Provider Demographics
NPI:1669587663
Name:HOPKINS, JEMERIE SHAWN
Entity type:Individual
Prefix:
First Name:JEMERIE
Middle Name:SHAWN
Last Name:HOPKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JEMERIE
Other - Middle Name:SHAWN
Other - Last Name:HUSZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2867 RIVERWOODS DR NE
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:MI
Mailing Address - Zip Code:49341-9294
Mailing Address - Country:US
Mailing Address - Phone:414-305-1635
Mailing Address - Fax:
Practice Address - Street 1:2867 RIVERWOODS DR NE
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:MI
Practice Address - Zip Code:49341-9294
Practice Address - Country:US
Practice Address - Phone:414-305-1635
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2013-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1930808OtherMI OT LICENSE
IL056007129OtherLICENSE #