Provider Demographics
NPI:1467099002
Name:HOPKINSON, DONNA SHANELLE (RN, LMT)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:SHANELLE
Last Name:HOPKINSON
Suffix:
Gender:F
Credentials:RN, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3301 E THOMAS RD STE A
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-7302
Mailing Address - Country:US
Mailing Address - Phone:480-567-0236
Mailing Address - Fax:
Practice Address - Street 1:3301 E THOMAS RD STE A
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-7302
Practice Address - Country:US
Practice Address - Phone:480-567-0236
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-03
Last Update Date:2019-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN210163163WM1400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WM1400XNursing Service ProvidersRegistered NurseNurse Massage Therapist (NMT)Group - Multi-Specialty