Provider Demographics
NPI:1972956100
Name:POPE, ROSALIE
Entity Type:Individual
Prefix:
First Name:ROSALIE
Middle Name:
Last Name:POPE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 HARBOUR COVE DR APT 102
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89434-7862
Mailing Address - Country:US
Mailing Address - Phone:775-636-6269
Mailing Address - Fax:775-359-3520
Practice Address - Street 1:350 HARBOUR COVE DR APT 102
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89434-7862
Practice Address - Country:US
Practice Address - Phone:775-636-6269
Practice Address - Fax:775-359-3520
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-23
Last Update Date:2016-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV8588-PCO-0253Z00000X
NV20141164137251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Yes253Z00000XAgenciesIn Home Supportive Care