Healthcare Provider Details

I. General information

NPI: 1376539262
Provider Name (Legal Business Name): TANYA M HOPKINS FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TANYA M CONNOLLY FNP

II. Dates (important events)

Enumeration Date: 09/26/2005
Last Update Date: 03/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

362 COURT ST
PLYMOUTH MA
02360-4397
US

IV. Provider business mailing address

139 SANDWICH ST
PLYMOUTH MA
02360-2449
US

V. Phone/Fax

Practice location:
  • Phone: 508-746-7543
  • Fax: 508-746-1334
Mailing address:
  • Phone: 508-746-5773
  • Fax: 508-747-8274

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number237686
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: