Provider Demographics
NPI:1760161020
Name:POPE, BARBERA A (AQUATIC INSTRUCTOR)
Entity type:Individual
Prefix:
First Name:BARBERA
Middle Name:A
Last Name:POPE
Suffix:
Gender:F
Credentials:AQUATIC INSTRUCTOR
Other - Prefix:
Other - First Name:BARBIE
Other - Middle Name:
Other - Last Name:P
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FITNESS INSTRUCTOR
Mailing Address - Street 1:6622 MAPLEWOOD RD APT 203
Mailing Address - Street 2:
Mailing Address - City:MAYFIELD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44124-1947
Mailing Address - Country:US
Mailing Address - Phone:248-773-2102
Mailing Address - Fax:
Practice Address - Street 1:6622 MAPLEWOOD RD APT 203
Practice Address - Street 2:
Practice Address - City:MAYFIELD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44124-1947
Practice Address - Country:US
Practice Address - Phone:248-773-2102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-13
Last Update Date:2025-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH372500000X, 372600000X, 374U00000X
376J00000X
OHMT90705171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171400000XOther Service ProvidersHealth & Wellness Coach
No372500000XNursing Service Related ProvidersChore Provider
No372600000XNursing Service Related ProvidersAdult Companion
No374U00000XNursing Service Related ProvidersHome Health Aide
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty