Healthcare Provider Details

I. General information

NPI: 1750629804
Provider Name (Legal Business Name): CYNTHIA SUE HOPPER ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/24/2013
Last Update Date: 01/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2484 N ESSEX AVE
HERNANDO FL
34442-5321
US

IV. Provider business mailing address

2484 N ESSEX AVE
HERNANDO FL
34442-5321
US

V. Phone/Fax

Practice location:
  • Phone: 352-746-1358
  • Fax: 352-746-1972
Mailing address:
  • Phone: 352-746-1358
  • Fax: 352-746-1972

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN2571812
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: