Provider Demographics
NPI:1285425645
Name:POPE, JACOB
Entity type:Individual
Prefix:
First Name:JACOB
Middle Name:
Last Name:POPE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 GOLD COAST RD APT 7
Mailing Address - Street 2:
Mailing Address - City:PAPILLION
Mailing Address - State:NE
Mailing Address - Zip Code:68046-2869
Mailing Address - Country:US
Mailing Address - Phone:402-813-6914
Mailing Address - Fax:
Practice Address - Street 1:1215 GOLD COAST RD APT 7
Practice Address - Street 2:
Practice Address - City:PAPILLION
Practice Address - State:NE
Practice Address - Zip Code:68046-2869
Practice Address - Country:US
Practice Address - Phone:402-813-6914
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-15
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker