Provider Demographics
NPI:1376524975
Name:HOPKINS, DONNA L (PT)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:L
Last Name:HOPKINS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 667744
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28266-7744
Mailing Address - Country:US
Mailing Address - Phone:704-596-6663
Mailing Address - Fax:704-597-5313
Practice Address - Street 1:10810 MALLARD CREEK RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-9786
Practice Address - Country:US
Practice Address - Phone:704-510-8011
Practice Address - Fax:704-510-8029
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-10
Last Update Date:2009-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1604225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0788XOtherBCBS
NC7698177OtherAETNA
NC7698177OtherAETNA