Healthcare Provider Details

I. General information

NPI: 1366498925
Provider Name (Legal Business Name): TERESA ANN HOPKINS CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 06/22/2023
Certification Date: 06/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

163 VAN BUREN RD STE 1
CARIBOU ME
04736-3588
US

IV. Provider business mailing address

3298 COQUINA KEY DR SE
ST PETERSBURG FL
33705-4147
US

V. Phone/Fax

Practice location:
  • Phone: 207-498-1124
  • Fax: 727-821-2871
Mailing address:
  • Phone: 727-821-2871
  • Fax: 727-828-0723

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberARNP9172191
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: