Healthcare Provider Details

I. General information

NPI: 1780342691
Provider Name (Legal Business Name): SARAH HOPPER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/08/2021
Last Update Date: 12/08/2021
Certification Date: 12/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 N HURSTBOURNE PKWY STE 220
LOUISVILLE KY
40222-5185
US

IV. Provider business mailing address

1002 RUELAND DR
LAWRENCEBURG KY
40342-9093
US

V. Phone/Fax

Practice location:
  • Phone: 502-509-1928
  • Fax:
Mailing address:
  • Phone: 502-517-2551
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SL0600X
TaxonomyLong-Term Care Clinical Nurse Specialist
License Number1156402
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: