Basic Information
| Provider Information | |||||||||
| NPI: | 1255804019 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HOPKINS | ||||||||
| FirstName: | KERRI | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3913 GEORGETOWN RD NW | ||||||||
| Address2: | |||||||||
| City: | CLEVELAND | ||||||||
| State: | TN | ||||||||
| PostalCode: | 373121806 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4234793600 | ||||||||
| FaxNumber: | 4233031234 | ||||||||
| Practice Location | |||||||||
| Address1: | 3913 GEORGETOWN RD NW | ||||||||
| Address2: | |||||||||
| City: | CLEVELAND | ||||||||
| State: | TN | ||||||||
| PostalCode: | 373121806 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4234793600 | ||||||||
| FaxNumber: | 4233031234 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/04/2019 | ||||||||
| LastUpdateDate: | 01/04/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 25248 | TN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.