Provider Demographics
NPI:1376539262
Name:HOPKINS, TANYA M (FNP)
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:M
Last Name:HOPKINS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:TANYA
Other - Middle Name:M
Other - Last Name:CONNOLLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:139 SANDWICH ST
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-2449
Mailing Address - Country:US
Mailing Address - Phone:508-746-5773
Mailing Address - Fax:508-747-8274
Practice Address - Street 1:362 COURT ST
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-4397
Practice Address - Country:US
Practice Address - Phone:508-746-7543
Practice Address - Fax:508-746-1334
Is Sole Proprietor?:No
Enumeration Date:2005-09-26
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA237686363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0716634Medicaid
MANP4341OtherBLUE CROSS BLUE SHIELD
MANP4341OtherBLUE CROSS BLUE SHIELD
MANP4341Medicare PIN