Provider Demographics
NPI:1134779598
Name:HOPKINS, LAURA MARIE
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:MARIE
Last Name:HOPKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 728
Mailing Address - Street 2:
Mailing Address - City:EVART
Mailing Address - State:MI
Mailing Address - Zip Code:49631-0728
Mailing Address - Country:US
Mailing Address - Phone:231-734-5936
Mailing Address - Fax:231-734-3545
Practice Address - Street 1:1375 CHAPUT DR
Practice Address - Street 2:
Practice Address - City:SEARS
Practice Address - State:MI
Practice Address - Zip Code:49679-8064
Practice Address - Country:US
Practice Address - Phone:231-734-5936
Practice Address - Fax:231-734-3545
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-18
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home