Provider Demographics
NPI:1801999198
Name:HOPPE, CHRISTINE ANN (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:ANN
Last Name:HOPPE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:ANN
Other - Last Name:HENDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:360 PEAK ONE DRIVE
Mailing Address - Street 2:SUITE 100 PO BOX 4337
Mailing Address - City:FRISCO
Mailing Address - State:CO
Mailing Address - Zip Code:80443
Mailing Address - Country:US
Mailing Address - Phone:970-668-4040
Mailing Address - Fax:970-668-6699
Practice Address - Street 1:360 PEAK ONE DR.
Practice Address - Street 2:#100
Practice Address - City:FRISCO
Practice Address - State:CO
Practice Address - Zip Code:80443
Practice Address - Country:US
Practice Address - Phone:970-668-4040
Practice Address - Fax:970-668-6699
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO39789207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO99739852Medicaid
H89564Medicare UPIN
CO504278Medicare ID - Type UnspecifiedKEYSTONE MEDICAL CTR
COCOA104373Medicare PIN
COCO301527Medicare PIN