Provider Demographics
NPI:1497110886
Name:HOPE PRIMARY CARE, PLLC
Entity Type:Organization
Organization Name:HOPE PRIMARY CARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:
Authorized Official - Last Name:COPLON
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, DCC
Authorized Official - Phone:901-512-4632
Mailing Address - Street 1:PO BOX 770750
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38177-0750
Mailing Address - Country:US
Mailing Address - Phone:901-512-4632
Mailing Address - Fax:901-512-4684
Practice Address - Street 1:675 OAKLEAF OFFICE LN STE 200
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38117-4863
Practice Address - Country:US
Practice Address - Phone:901-512-4632
Practice Address - Fax:901-512-4684
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-29
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN13565363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1477706836OtherNPI