Provider Demographics
NPI:1093992950
Name:HOPKINS, REGINA (RN)
Entity Type:Individual
Prefix:
First Name:REGINA
Middle Name:
Last Name:HOPKINS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:427 PIPE STAVE HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:MILLER PLACE
Mailing Address - State:NY
Mailing Address - Zip Code:11764-0901
Mailing Address - Country:US
Mailing Address - Phone:631-928-2074
Mailing Address - Fax:
Practice Address - Street 1:427 PIPE STAVE HOLLOW RD
Practice Address - Street 2:POB 901
Practice Address - City:MILLER PLACE
Practice Address - State:NY
Practice Address - Zip Code:11764-0901
Practice Address - Country:US
Practice Address - Phone:631-928-2074
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-23
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY6125386163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02865245Medicaid