Provider Demographics
NPI:1588327902
Name:POPE, MONICA DENISE (FNP-C)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:DENISE
Last Name:POPE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4946 HUNTSWOOD PL
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91737-1680
Mailing Address - Country:US
Mailing Address - Phone:909-360-1315
Mailing Address - Fax:
Practice Address - Street 1:4946 HUNTSWOOD PL
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91737-1680
Practice Address - Country:US
Practice Address - Phone:909-360-1315
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-21
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95016991363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty