Provider Demographics
NPI:1821057969
Name:POPE, NORMA JEAN (WHCNP)
Entity Type:Individual
Prefix:
First Name:NORMA
Middle Name:JEAN
Last Name:POPE
Suffix:
Gender:F
Credentials:WHCNP
Other - Prefix:
Other - First Name:NORMA
Other - Middle Name:JEAN
Other - Last Name:NEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:WHCNP
Mailing Address - Street 1:1313 BROADWAY
Mailing Address - Street 2:SUITE 5
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79401-3277
Mailing Address - Country:US
Mailing Address - Phone:806-765-2600
Mailing Address - Fax:806-765-2604
Practice Address - Street 1:1318 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79401-3206
Practice Address - Country:US
Practice Address - Phone:806-765-2611
Practice Address - Fax:806-741-3014
Is Sole Proprietor?:No
Enumeration Date:2006-03-18
Last Update Date:2013-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX563722208800000X, 364SW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SW0102XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistWomen's Health
No208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX121362105Medicaid
P20464Medicare UPIN
TX121362105Medicaid