Provider Demographics
NPI:1780833558
Name:HOPSON, TAMMY LYNETTA (LPN)
Entity Type:Individual
Prefix:MISS
First Name:TAMMY
Middle Name:LYNETTA
Last Name:HOPSON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13720 DARLEY AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44110-2124
Mailing Address - Country:US
Mailing Address - Phone:216-268-5686
Mailing Address - Fax:
Practice Address - Street 1:13720 DARLEY AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44110-2124
Practice Address - Country:US
Practice Address - Phone:216-268-5686
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-16
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH118655164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse