Provider Demographics
NPI:1952800641
Name:POPE, LISA KAREN (NP)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:KAREN
Last Name:POPE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:229 RIDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:TRUSSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35173-1817
Mailing Address - Country:US
Mailing Address - Phone:205-527-1261
Mailing Address - Fax:205-655-4777
Practice Address - Street 1:229 RIDGEWOOD DR
Practice Address - Street 2:
Practice Address - City:TRUSSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35173-1817
Practice Address - Country:US
Practice Address - Phone:205-527-1261
Practice Address - Fax:205-655-4777
Is Sole Proprietor?:No
Enumeration Date:2018-02-07
Last Update Date:2018-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-068449163WH0200X
AL1-064889363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163WH0200XNursing Service ProvidersRegistered NurseHome Health