Healthcare Provider Details

I. General information

NPI: 1255268173
Provider Name (Legal Business Name): CATOYHA MICHELL HOPSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 DEER RIDGE CV
BRANDON MS
39042-7216
US

IV. Provider business mailing address

3122 LAKEWOOD DR
JACKSON MS
39212-4026
US

V. Phone/Fax

Practice location:
  • Phone: 769-601-6716
  • Fax:
Mailing address:
  • Phone: 769-601-6716
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number801363383
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: