Provider Demographics
NPI:1801278197
Name:HOPSON, PHILLIS ELAINE (FNP)
Entity type:Individual
Prefix:
First Name:PHILLIS
Middle Name:ELAINE
Last Name:HOPSON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:PHILLIS
Other - Middle Name:ELAINE
Other - Last Name:HOPSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP
Mailing Address - Street 1:UNIVERSITY OF ALABAMA AT BIRMINGHAM
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35233
Mailing Address - Country:US
Mailing Address - Phone:205-934-4011
Mailing Address - Fax:
Practice Address - Street 1:1720 2ND AVE S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-1806
Practice Address - Country:US
Practice Address - Phone:205-934-4011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-23
Last Update Date:2015-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR855193363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily