MEDICARE: DIANNA 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	237700000X	Hearing Instrument Specialist	3501006357	MI

General Provider Information

NPI Number	:	1174981849
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIANNA HOPKINS

Provider Business Mailing Address
First Line	:	89 54TH ST SW
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49548-5503
Country	:	US
Telephone Number	:	616-530-8883
Fax Number	:	616-530-8997

Provider Business Practice Location Address
First Line	:	89 54TH ST SW
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49548-5503
Country	:	US
Telephone Number	:	616-530-8883
Fax Number	:	616-530-8997

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

Provider Enumeration Date	:	02/09/2016
Last Update Date	:	02/09/2016

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Directions to “ DIANNA HOPKINS ” Practice Location

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