Provider Demographics
NPI:1699021584
Name:HOPP, CAROL JEAN (RPH)
Entity Type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:JEAN
Last Name:HOPP
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:712 38TH ST NW
Mailing Address - Street 2:SUITE A
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58102-2955
Mailing Address - Country:US
Mailing Address - Phone:701-893-9217
Mailing Address - Fax:701-893-9222
Practice Address - Street 1:712 38TH ST NW
Practice Address - Street 2:SUITE A
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58102-2955
Practice Address - Country:US
Practice Address - Phone:701-893-9217
Practice Address - Fax:701-893-9222
Is Sole Proprietor?:No
Enumeration Date:2012-07-28
Last Update Date:2012-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND2875183500000X
MN114925183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist