Healthcare Provider Details

I. General information

NPI: 1538412846
Provider Name (Legal Business Name): MEGAN R HOPP NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2012
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 KENOSHA ST STE A
WALWORTH WI
53184-9512
US

IV. Provider business mailing address

525 KENOSHA ST STE A
WALWORTH WI
53184-9512
US

V. Phone/Fax

Practice location:
  • Phone: 262-275-2101
  • Fax:
Mailing address:
  • Phone: 262-275-2101
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA138786
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5116
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: