1558481077 NPI number — MRS. DENISE LYNNE POPE-WOODS RN

Table of content: MRS. DENISE LYNNE POPE-WOODS RN (NPI 1558481077)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558481077 NPI number — MRS. DENISE LYNNE POPE-WOODS RN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
POPE-WOODS
Provider First Name:
DENISE
Provider Middle Name:
LYNNE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
RN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1558481077
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5660 ELGIN ROOF RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DAYTON
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45426-1816
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
937-660-3097
Provider Business Mailing Address Fax Number:
937-660-3093

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5660 ELGIN ROOF RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DAYTON
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45426-1816
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
937-660-3097
Provider Business Practice Location Address Fax Number:
937-660-3093
Provider Enumeration Date:
03/29/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163W00000X , with the licence number:  RN246828 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com