Provider Demographics
NPI:1730290834
Name:POPE, EMILY ANN FERRELL (NP)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:ANN FERRELL
Last Name:POPE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:ANN
Other - Last Name:FERRELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:500 DOYLE PARK DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95405-4558
Mailing Address - Country:US
Mailing Address - Phone:707-544-6090
Mailing Address - Fax:707-544-2389
Practice Address - Street 1:500 DOYLE PARK DR
Practice Address - Street 2:SUITE 100
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95405-4558
Practice Address - Country:US
Practice Address - Phone:707-544-6090
Practice Address - Fax:707-544-2389
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2015-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN11759363LP0200X
CARN639980163W00000X
CANP95003418363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163W00000XNursing Service ProvidersRegistered Nurse