Healthcare Provider Details

I. General information

NPI: 1245502202
Provider Name (Legal Business Name): MS. DONNA RENEE HOPKINS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/06/2012
Last Update Date: 02/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8622A W APPLETON AVE
MILWAUKEE WI
53225-4229
US

IV. Provider business mailing address

8622A W APPLETON AVE
MILWAUKEE WI
53225-4229
US

V. Phone/Fax

Practice location:
  • Phone: 414-949-0311
  • Fax:
Mailing address:
  • Phone: 414-949-0311
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number210215
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number201215
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: