MEDICARE: MRS. ALISHA HOPKINS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	COA.18381-NP	OH

General Provider Information

NPI Number	:	1013380120
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ALISHA HOPKINS

Provider Business Mailing Address
First Line	:	1520 OLD HENDERSON RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43220-3639
Country	:	US
Telephone Number	:	614-457-4570
Fax Number	:

Provider Business Practice Location Address
First Line	:	1520 OLD HENDERSON RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43220-3639
Country	:	US
Telephone Number	:	614-457-4570
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/11/2015
Last Update Date	:	01/30/2018

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