Individual
LAUREL POPE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA C
Contact information
Practice address
7061 GRAND MONTECITO PKWY, LAS VEGAS, NV 89149-0287
(702) 750-3900
(702) 750-3853
Mailing address
PO BOX 15645, LAS VEGAS, NV 89114-5645
(702) 750-3900
(702) 750-3853
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
PA 8960
NV
363A00000X
Physician Assistant
Primary
PA896
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100505472
—
NV
01
—
100505473
MEDICAID
NV
Enumeration date
01/31/2006
Last updated
02/14/2014
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