Provider Demographics
NPI:1629429634
Name:HOPKINS, CAROL
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:HOPKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9200 BUSTLETON AVE
Mailing Address - Street 2:APT# 205
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19115-4269
Mailing Address - Country:US
Mailing Address - Phone:215-904-5976
Mailing Address - Fax:
Practice Address - Street 1:500 OFFICE CENTER DR
Practice Address - Street 2:SUITE# 400
Practice Address - City:FORT WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:19034-3219
Practice Address - Country:US
Practice Address - Phone:267-513-1995
Practice Address - Fax:267-513-1729
Is Sole Proprietor?:No
Enumeration Date:2016-06-30
Last Update Date:2016-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN259602L164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse