Provider Demographics
NPI:1164183521
Name:POPE, MEGAN MARIE (NP)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:MARIE
Last Name:POPE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:M
Other - Last Name:O'CONNOR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:803 COFFEE RD STE 10
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95355-4244
Mailing Address - Country:US
Mailing Address - Phone:209-402-3760
Mailing Address - Fax:
Practice Address - Street 1:803 COFFEE RD STE 10
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95355-4244
Practice Address - Country:US
Practice Address - Phone:209-402-3760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-06
Last Update Date:2025-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95019582363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily