Provider Demographics
NPI:1841656063
Name:HOPPER, KATHERINE ROSE (CRNA)
Entity type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:ROSE
Last Name:HOPPER
Suffix:
Gender:F
Credentials:CRNA
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Mailing Address - Street 1:3100 SPRING FOREST RD STE 130
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27616-2880
Mailing Address - Country:US
Mailing Address - Phone:919-882-0705
Mailing Address - Fax:919-873-9821
Practice Address - Street 1:5855 BREMO RD
Practice Address - Street 2:SUITE 100 MEDICAL BUILDING NORTH
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-1930
Practice Address - Country:US
Practice Address - Phone:804-673-1038
Practice Address - Fax:804-673-1038
Is Sole Proprietor?:No
Enumeration Date:2016-01-04
Last Update Date:2016-03-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0024173242367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered