Provider Demographics
NPI:1598734220
Name:HOPKINS, DEBOREE I (RN)
Entity Type:Individual
Prefix:MS
First Name:DEBOREE
Middle Name:I
Last Name:HOPKINS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N9334 WARNER RD
Mailing Address - Street 2:
Mailing Address - City:WHITEWATER
Mailing Address - State:WI
Mailing Address - Zip Code:53190-3700
Mailing Address - Country:US
Mailing Address - Phone:262-472-8923
Mailing Address - Fax:262-472-9555
Practice Address - Street 1:505 STOUGHTON RD
Practice Address - Street 2:
Practice Address - City:EDGERTON
Practice Address - State:WI
Practice Address - Zip Code:53534-1172
Practice Address - Country:US
Practice Address - Phone:608-884-3691
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-15
Last Update Date:2007-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI39887000Medicaid