Provider Demographics
NPI:1023410347
Name:HOPPER, LAURA JEAN (CPM)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:JEAN
Last Name:HOPPER
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1707 SCOTT DR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37777-5005
Mailing Address - Country:US
Mailing Address - Phone:435-669-5610
Mailing Address - Fax:
Practice Address - Street 1:2862 E OVERLOOK DR
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-6417
Practice Address - Country:US
Practice Address - Phone:435-669-5610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-17
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174N00000X
UT12304860-3400176B00000X
LA330193176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No174N00000XOther Service ProvidersLactation Consultant, Non-RN