Provider Demographics
NPI:1982818365
Name:HOPINKA, KIRK LAWRENCE (APNP)
Entity Type:Individual
Prefix:
First Name:KIRK
Middle Name:LAWRENCE
Last Name:HOPINKA
Suffix:
Gender:M
Credentials:APNP
Other - Prefix:
Other - First Name:KIRK
Other - Middle Name:LAWRENCE
Other - Last Name:DECORA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APNP
Mailing Address - Street 1:720 WISCONSIN ST
Mailing Address - Street 2:
Mailing Address - City:WISCONSIN RAPIDS
Mailing Address - State:WI
Mailing Address - Zip Code:54494-3645
Mailing Address - Country:US
Mailing Address - Phone:715-421-1870
Mailing Address - Fax:
Practice Address - Street 1:N6520 GUY RD
Practice Address - Street 2:
Practice Address - City:BLACK RIVER FALLS
Practice Address - State:WI
Practice Address - Zip Code:54615-5405
Practice Address - Country:US
Practice Address - Phone:715-284-9851
Practice Address - Fax:715-284-3434
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1775033363LP0808X
TX507003364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Not Answered364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health