MEDICARE: MS. TERESA B HOPKINS FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	201040	NC

General Provider Information

NPI Number	:	1366517872
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TERESA B HOPKINS FNP

Provider Business Mailing Address
First Line	:	107 CHURCH ST
Second Line	:
City	:	LAKE WACCAMAW
State	:	NC
Zip	:	28450-1909
Country	:	US
Telephone Number	:	910-646-2107
Fax Number	:	910-646-2252

Provider Business Practice Location Address
First Line	:	107 CHURCH ST
Second Line	:
City	:	LAKE WACCAMAW
State	:	NC
Zip	:	28450-1909
Country	:	US
Telephone Number	:	910-646-2107
Fax Number	:	910-646-2252

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/21/2006
Last Update Date	:	01/23/2024

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