Healthcare Provider Details

I. General information

NPI: 1134050529
Provider Name (Legal Business Name): CHARLYNN DEANA HOPTRY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

253 S LEXINGTON SPRINGMILL RD
MANSFIELD OH
44906-1329
US

IV. Provider business mailing address

253 S LEXINGTON SPRINGMILL RD
MANSFIELD OH
44906-1329
US

V. Phone/Fax

Practice location:
  • Phone: 567-241-8619
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberRN.460176
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: