Provider Demographics
NPI:1194386573
Name:HOPF, MELANIE (PA-C)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:HOPF
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:MELANIE
Other - Middle Name:
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:PO BOX 21890
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-4115
Mailing Address - Country:US
Mailing Address - Phone:502-907-0356
Mailing Address - Fax:502-919-9780
Practice Address - Street 1:1025 1ST AVE W
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:IN
Practice Address - Zip Code:47546-3217
Practice Address - Country:US
Practice Address - Phone:812-476-7111
Practice Address - Fax:812-476-7117
Is Sole Proprietor?:No
Enumeration Date:2019-06-26
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
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IN300029983Medicaid
6810994OtherCIGNA PROVIDER ID NUMBER
KY7100620060Medicaid
CS2000300388OtherCARESOURCE PROVIDER ID NUMBER
KYPDZ000000326011OtherAETNA BETTER HEALTH OF KY PROVIDER ID NUMBER
KY2013903OtherWELLCARE OF KY PROVIDER ID NUMBER