Provider Demographics
NPI:1407230915
Name:HOPKINS, JOANNA (RN)
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:
Last Name:HOPKINS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 SMITH ST
Mailing Address - Street 2:
Mailing Address - City:NESCONSET
Mailing Address - State:NY
Mailing Address - Zip Code:11767-3329
Mailing Address - Country:US
Mailing Address - Phone:631-619-6232
Mailing Address - Fax:
Practice Address - Street 1:38 SMITH ST
Practice Address - Street 2:
Practice Address - City:NESCONSET
Practice Address - State:NY
Practice Address - Zip Code:11767-3329
Practice Address - Country:US
Practice Address - Phone:631-619-6232
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-14
Last Update Date:2015-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY588074163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse