Healthcare Provider Details

I. General information

NPI: 1164066262
Provider Name (Legal Business Name): KAYLEA MARIE HOPKINS FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2019
Last Update Date: 06/02/2024
Certification Date: 06/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7858 N SILVER RANCH RD
EAGLE MOUNTAIN UT
84005-5854
US

IV. Provider business mailing address

7858 N SILVER RANCH RD
EAGLE MOUNTAIN UT
84005-5854
US

V. Phone/Fax

Practice location:
  • Phone: 518-879-5986
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number2024014170
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number11297752-3101
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: