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KORENA POPP FNP MEDICAL SERVICES LLC
NPI 1093368276
Clinic/Center in Donnelly, ID

Active since July 17, 2019
454 W ROSEBERRY RD. STE 104, DONNELLY, ID 83615(208) 325-3500(208) 325-3501 Get Directions Write a Review

NPPES record last updated: July 17, 2019. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Korena Popp Fnp Medical Services Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KORENA POPP FNP MEDICAL SERVICES LLC (NPI 1093368276), doing business as The Change Clinic, is a healthcare organization registered as a clinic/center in Donnelly, Idaho and active in the NPI registry since July 2019. The organization lists Korena Lynn Popp, Np, as its authorized official.

NPPES Registry Identity

NPI1093368276
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameKORENA POPP FNP MEDICAL SERVICES LLC
Location Address454 W ROSEBERRY RD. STE 104Donnelly, ID 83615-8361
Mailing AddressPo Box 172Donnelly, ID 83615-0172 · (208) 325-3500 · Fax (208) 325-3501
Phone(208) 325-3500
Fax(208) 325-3501
Organization SubpartNo
Authorized OfficialKorena Lynn PoppNp · (208) 325-3500
Enumeration DateJuly 17, 2019
✔ NPI 1093368276 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
Definition

A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

454 W ROSEBERRY RD. STE 104, Donnelly, ID 83615
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Other Names 1

Doing Business AsThe Change Clinic

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Korena Popp Fnp Medical Services LLC's NPI number?

The NPI number for Korena Popp Fnp Medical Services LLC is 1093368276. It was assigned to this organization in the NPPES registry on July 17, 2019. The provider is doing business as The Change Clinic.

Where is Korena Popp Fnp Medical Services LLC located?

Korena Popp Fnp Medical Services LLC is located at 454 W Roseberry Rd. Ste 104, Donnelly, ID 83615. The listed phone number is (208) 325-3500.

What is Korena Popp Fnp Medical Services LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

When was this NPI record last updated?

The NPPES record for Korena Popp Fnp Medical Services LLC was last updated on July 17, 2019. NPI Profile syncs with the weekly NPPES data releases published by CMS.