Provider Demographics
NPI:1558739375
Name:HOPKINS, PAMELA (AGNP)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:HOPKINS
Suffix:
Gender:F
Credentials:AGNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8214 SPRINGDALE DR
Mailing Address - Street 2:
Mailing Address - City:WHITE LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:48386-4544
Mailing Address - Country:US
Mailing Address - Phone:989-860-2080
Mailing Address - Fax:
Practice Address - Street 1:8214 SPRINGDALE DR
Practice Address - Street 2:
Practice Address - City:WHITE LAKE
Practice Address - State:MI
Practice Address - Zip Code:48386-4544
Practice Address - Country:US
Practice Address - Phone:989-860-2080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-10
Last Update Date:2015-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704220419363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology