Provider Demographics
NPI:1518133487
Name:HOPE, JENNIFER DAWN (PMHNP-BC, FNP-BC)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:DAWN
Last Name:HOPE
Suffix:
Gender:F
Credentials:PMHNP-BC, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:137 HALL AVE
Mailing Address - Street 2:
Mailing Address - City:COOS BAY
Mailing Address - State:OR
Mailing Address - Zip Code:97420-1519
Mailing Address - Country:US
Mailing Address - Phone:541-236-2086
Mailing Address - Fax:541-214-2897
Practice Address - Street 1:632 ANDERSON AVE
Practice Address - Street 2:
Practice Address - City:COOS BAY
Practice Address - State:OR
Practice Address - Zip Code:97420-1632
Practice Address - Country:US
Practice Address - Phone:541-236-2086
Practice Address - Fax:541-214-2897
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-01
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV57340363LF0000X
OR202113001NP-PP363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500794087Medicaid