Individual
VIDA GRETCHEN POPE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2171 W PARK CT, SUITE A, STONE MOUNTAIN, GA 30087-3555
(678) 514-1991
Mailing address
2171 W PARK CT, SUITE A, STONE MOUNTAIN, GA 30087-3555
(678) 514-1991
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN046765
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000511046B
—
GA
Enumeration date
02/15/2007
Last updated
07/18/2008
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