MEDICARE: KERRI HOPKINS NP

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	363L00000X	Nurse Practitioner	25248	TN

General Provider Information

NPI Number	:	1255804019
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KERRI HOPKINS NP

Provider Business Mailing Address
First Line	:	3913 GEORGETOWN RD NW
Second Line	:
City	:	CLEVELAND
State	:	TN
Zip	:	37312-1806
Country	:	US
Telephone Number	:	423-479-3600
Fax Number	:	423-303-1234

Provider Business Practice Location Address
First Line	:	3913 GEORGETOWN RD NW
Second Line	:
City	:	CLEVELAND
State	:	TN
Zip	:	37312-1806
Country	:	US
Telephone Number	:	423-479-3600
Fax Number	:	423-303-1234

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

Provider Enumeration Date	:	01/04/2019
Last Update Date	:	01/04/2019

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