Provider Demographics
NPI:1487760260
Name:POPE, DOROTHY ANN (APN)
Entity type:Individual
Prefix:MRS
First Name:DOROTHY
Middle Name:ANN
Last Name:POPE
Suffix:
Gender:F
Credentials:APN
Other - Prefix:MRS
Other - First Name:DOTTIE
Other - Middle Name:A
Other - Last Name:POPE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APN
Mailing Address - Street 1:18276 PONDEROSA DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72764-9061
Mailing Address - Country:US
Mailing Address - Phone:479-751-8475
Mailing Address - Fax:
Practice Address - Street 1:525 N GARLAND AVE
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72701-3110
Practice Address - Country:US
Practice Address - Phone:479-575-4478
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAO1522363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR1432OtherPRECRIPTIVE AUTHORITY ARK
ARAO1522OtherARKANSAS LICENSE NUMBER
ARAO1522OtherARKANSAS LICENSE NUMBER