Provider Demographics
NPI:1437961752
Name:POPE, POLLY L
Entity type:Individual
Prefix:
First Name:POLLY
Middle Name:L
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 1:348 W 21ST AVE
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:NE
Mailing Address - Zip Code:68025-2525
Mailing Address - Country:US
Mailing Address - Phone:402-317-1909
Mailing Address - Fax:
Practice Address - Street 1:207 N PINE ST
Practice Address - Street 2:
Practice Address - City:HOOPER
Practice Address - State:NE
Practice Address - Zip Code:68031-3072
Practice Address - Country:US
Practice Address - Phone:402-654-2024
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-23
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide