Provider Demographics
NPI:1114571700
Name:HOPPER, MIRANDA COLE (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:MIRANDA
Middle Name:COLE
Last Name:HOPPER
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:MIRANDA
Other - Middle Name:COLE
Other - Last Name:MAJORINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2415 OSBORNE DR E STE 100
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:NE
Mailing Address - Zip Code:68901-1999
Mailing Address - Country:US
Mailing Address - Phone:402-462-2929
Mailing Address - Fax:
Practice Address - Street 1:2415 OSBORNE DR E STE 100
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:NE
Practice Address - Zip Code:68901-1999
Practice Address - Country:US
Practice Address - Phone:402-462-2929
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-31
Last Update Date:2019-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE16544183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist