Healthcare Provider Details

I. General information

NPI: 1720812407
Provider Name (Legal Business Name): DIANA HOPKINS CPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/27/2024
Last Update Date: 08/27/2024
Certification Date: 08/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4386 LINDELL BLVD STE 105
SAINT LOUIS MO
63108-2702
US

IV. Provider business mailing address

710 LEGENDS VIEW DR
EUREKA MO
63025-2087
US

V. Phone/Fax

Practice location:
  • Phone: 573-701-7033
  • Fax:
Mailing address:
  • Phone: 573-701-7033
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: