Provider Demographics
NPI:1699373142
Name:HOPKINS, KAYLEE J (FNP)
Entity Type:Individual
Prefix:
First Name:KAYLEE
Middle Name:J
Last Name:HOPKINS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:KAYLEE
Other - Middle Name:J
Other - Last Name:PEARSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1350 NE 122ND AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97230-2011
Mailing Address - Country:US
Mailing Address - Phone:503-408-7010
Mailing Address - Fax:
Practice Address - Street 1:1350 NE 122ND AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97230-2011
Practice Address - Country:US
Practice Address - Phone:503-408-7010
Practice Address - Fax:503-408-7035
Is Sole Proprietor?:No
Enumeration Date:2020-10-15
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR10015657363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily