Healthcare Provider Details

I. General information

NPI: 1497225510
Provider Name (Legal Business Name): ALLYSE HOPKINS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2018
Last Update Date: 12/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10701 EAST BLVD
CLEVELAND OH
44106-1702
US

IV. Provider business mailing address

8741 HAZELWOOD RUN
N RIDGEVILLE OH
44039-4541
US

V. Phone/Fax

Practice location:
  • Phone: 216-791-3800
  • Fax:
Mailing address:
  • Phone: 440-225-6507
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF06180900
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: