Provider Demographics
NPI:1629209721
Name:POPE-BAILEY, ANGELA DAWN (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:DAWN
Last Name:POPE-BAILEY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 FRISCO AVE
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:OK
Mailing Address - Zip Code:73601-3306
Mailing Address - Country:US
Mailing Address - Phone:580-323-2700
Mailing Address - Fax:580-323-2276
Practice Address - Street 1:800 FRISCO AVE
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:OK
Practice Address - Zip Code:73601-3306
Practice Address - Country:US
Practice Address - Phone:580-323-2700
Practice Address - Fax:580-323-2276
Is Sole Proprietor?:No
Enumeration Date:2009-08-06
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK69193363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200258350AMedicaid
OKOK403943Medicare PIN