Healthcare Provider Details

I. General information

NPI: 1952040644
Provider Name (Legal Business Name): KATHLEEN V HOPKINS MSN, RN, ACNS-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2022
Last Update Date: 06/01/2022
Certification Date: 06/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 SPRUCE ST
PHILADELPHIA PA
19104-4238
US

IV. Provider business mailing address

20 DORSET DR
BROOMALL PA
19008-3829
US

V. Phone/Fax

Practice location:
  • Phone: 215-221-2545
  • Fax:
Mailing address:
  • Phone: 610-545-9351
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN651348
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License NumberCNS00200
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: