Provider Demographics
NPI:1316246440
Name:POPE, NINA KATHRYN (PT)
Entity type:Individual
Prefix:MRS
First Name:NINA
Middle Name:KATHRYN
Last Name:POPE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5200 HIGHWAY 64 E
Mailing Address - Street 2:
Mailing Address - City:ALMA
Mailing Address - State:AR
Mailing Address - Zip Code:72921-7907
Mailing Address - Country:US
Mailing Address - Phone:479-997-1438
Mailing Address - Fax:
Practice Address - Street 1:1202 MAIN ST STE B
Practice Address - Street 2:
Practice Address - City:VAN BUREN
Practice Address - State:AR
Practice Address - Zip Code:72956-4560
Practice Address - Country:US
Practice Address - Phone:479-474-6444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-15
Last Update Date:2011-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR564225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist