Provider Demographics
NPI:1841632338
Name:HOPPE, PAMELA ANN (RN, BSN)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:ANN
Last Name:HOPPE
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4850 CENTURY PLAZA RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46254-5476
Mailing Address - Country:US
Mailing Address - Phone:317-216-2465
Mailing Address - Fax:317-216-2422
Practice Address - Street 1:4850 CENTURY PLAZA RD
Practice Address - Street 2:SUITE 100
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46254-5476
Practice Address - Country:US
Practice Address - Phone:317-216-2465
Practice Address - Fax:317-216-2422
Is Sole Proprietor?:No
Enumeration Date:2013-07-24
Last Update Date:2013-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28106603A163WX0106X
IN27024443A164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0106XNursing Service ProvidersRegistered NurseOccupational Health
No164W00000XNursing Service ProvidersLicensed Practical Nurse