Provider Demographics
NPI:1073731253
Name:HOPKINS, BILLIE RUTH
Entity Type:Individual
Prefix:
First Name:BILLIE
Middle Name:RUTH
Last Name:HOPKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26850 HIGHWAY 370
Mailing Address - Street 2:
Mailing Address - City:FALKNER
Mailing Address - State:MS
Mailing Address - Zip Code:38629-9549
Mailing Address - Country:US
Mailing Address - Phone:662-837-9077
Mailing Address - Fax:
Practice Address - Street 1:26850 HIGHWAY 370
Practice Address - Street 2:
Practice Address - City:FALKNER
Practice Address - State:MS
Practice Address - Zip Code:38629-9549
Practice Address - Country:US
Practice Address - Phone:662-837-9077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSP311382164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00770510Medicaid