Provider Demographics
NPI:1104940758
Name:POPP, MARGARET E (APRN-NP)
Entity type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:E
Last Name:POPP
Suffix:
Gender:F
Credentials:APRN-NP
Other - Prefix:MS
Other - First Name:MARGARET
Other - Middle Name:E
Other - Last Name:KELLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 E LIBERTY ST
Mailing Address - Street 2:SUITE 800
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-1434
Mailing Address - Country:US
Mailing Address - Phone:502-587-8222
Mailing Address - Fax:502-587-0860
Practice Address - Street 1:201 ABRAHAM FLEXNER WAY
Practice Address - Street 2:SUITE 100
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-3841
Practice Address - Country:US
Practice Address - Phone:502-587-8222
Practice Address - Fax:502-587-0860
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2016-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1049460163WM0705X
KY3007897363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100239410Medicaid
KYP01190191Medicare PIN
KYK080510Medicare PIN