Basic Information
| Provider Information | |||||||||
| NPI: | 1336603869 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | POPE | ||||||||
| FirstName: | AMBER | ||||||||
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| Credential: | AGNP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 620 OAKFIELD TRL | ||||||||
| Address2: | |||||||||
| City: | MEBANE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 273028870 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9199438864 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2301 ERWIN RD | ||||||||
| Address2: | |||||||||
| City: | DURHAM | ||||||||
| State: | NC | ||||||||
| PostalCode: | 277054699 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9196848964 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/29/2019 | ||||||||
| LastUpdateDate: | 01/29/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 5011343 | NC | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.