Provider Demographics
NPI:1679953897
Name:SAPP, FAVIA POPE (APRN)
Entity type:Individual
Prefix:
First Name:FAVIA
Middle Name:POPE
Last Name:SAPP
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:FAVIA
Other - Middle Name:CAROL
Other - Last Name:POPE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3151 BEAUMONT CENTRE CIR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40513-1959
Mailing Address - Country:US
Mailing Address - Phone:859-410-6101
Mailing Address - Fax:859-410-6102
Practice Address - Street 1:3151 BEAUMONT CENTRE CIR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40513-1959
Practice Address - Country:US
Practice Address - Phone:859-410-6101
Practice Address - Fax:859-410-6102
Is Sole Proprietor?:No
Enumeration Date:2015-06-03
Last Update Date:2016-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3009410363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily