Provider Demographics
NPI:1124594700
Name:HOPPE, MINDY LEIGH
Entity Type:Individual
Prefix:
First Name:MINDY
Middle Name:LEIGH
Last Name:HOPPE
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 1:230936 BUSINESS PARK DR
Mailing Address - Street 2:
Mailing Address - City:WAUSAU
Mailing Address - State:WI
Mailing Address - Zip Code:54403-5840
Mailing Address - Country:US
Mailing Address - Phone:715-849-5925
Mailing Address - Fax:
Practice Address - Street 1:230936 BUSINESS PARK DR
Practice Address - Street 2:
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54403-5840
Practice Address - Country:US
Practice Address - Phone:715-849-5925
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-22
Last Update Date:2018-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WH0202XOther Service ProvidersContractorHome Modifications