Healthcare Provider Details

I. General information

NPI: 1093578858
Provider Name (Legal Business Name): RENEE HOPKINS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/05/2024
Last Update Date: 02/05/2024
Certification Date: 02/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1835 RUTLAND AVE
CINCINNATI OH
45207-1219
US

IV. Provider business mailing address

1835 RUTLAND AVE
CINCINNATI OH
45207-1219
US

V. Phone/Fax

Practice location:
  • Phone: 513-807-6902
  • Fax: 513-531-0561
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License NumberRG967803
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License NumberRG967803
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: