Individual
TIFFANI IRENE POPP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1834 BROADWAY ST, CAPE GIRARDEAU, MO 63701-4553
(832) 869-4818
(832) 869-4818
Mailing address
1834 BROADWAY ST, CAPE GIRARDEAU, MO 63701-4553
(832) 869-4818
(832) 869-4853
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2021034612
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/27/2020
Last updated
11/19/2025
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