Provider Demographics
NPI:1558872192
Name:STOPKA, EMILY DOROTHEA (FNP)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:DOROTHEA
Last Name:STOPKA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5515
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97228-5515
Mailing Address - Country:US
Mailing Address - Phone:210-349-5577
Mailing Address - Fax:210-491-2819
Practice Address - Street 1:609 10TH AVE S
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405-4078
Practice Address - Country:US
Practice Address - Phone:406-430-1040
Practice Address - Fax:406-430-1041
Is Sole Proprietor?:No
Enumeration Date:2017-10-23
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT149865363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily