Provider Demographics
NPI:1841704988
Name:POPE, KELLY R (APRN)
Entity type:Individual
Prefix:MRS
First Name:KELLY
Middle Name:R
Last Name:POPE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2901 58TH AVE N.
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33714
Mailing Address - Country:US
Mailing Address - Phone:727-895-3702
Mailing Address - Fax:727-896-3828
Practice Address - Street 1:6331 STATE RD 54
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34653
Practice Address - Country:US
Practice Address - Phone:727-351-8121
Practice Address - Fax:727-834-9995
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-28
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2556022363LF0000X
FLAPRN2556022363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily