Healthcare Provider Details

I. General information

NPI: 1780963934
Provider Name (Legal Business Name): JENNIFER LYNN HOPGOOD FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER LYNN ALAM NP

II. Dates (important events)

Enumeration Date: 08/05/2011
Last Update Date: 03/24/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 CLINTON ST
WOONSOCKET RI
02895-3207
US

IV. Provider business mailing address

450 CLINTON ST
WOONSOCKET RI
02895-3207
US

V. Phone/Fax

Practice location:
  • Phone: 401-767-4100
  • Fax: 401-356-4709
Mailing address:
  • Phone: 401-767-4100
  • Fax: 401-356-4709

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN2263972
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN00275
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: