Healthcare Provider Details

I. General information

NPI: 1982818365
Provider Name (Legal Business Name): KIRK LAWRENCE HOPINKA APNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: KIRK LAWRENCE DECORA APNP

II. Dates (important events)

Enumeration Date: 05/09/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

N6520 GUY RD
BLACK RIVER FALLS WI
54615-5405
US

IV. Provider business mailing address

720 WISCONSIN ST
WISCONSIN RAPIDS WI
54494-3645
US

V. Phone/Fax

Practice location:
  • Phone: 715-284-9851
  • Fax: 715-284-3434
Mailing address:
  • Phone: 715-421-1870
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number1775033
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License Number507003
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: