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NPI Code Detail

MEDICARE: DONNA SHANELLE HOPKINSON RN, LMT

MEDICARE: DONNA SHANELLE HOPKINSON RN, LMT
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
1163WM1400XNurse Massage Therapist (NMT)RN210163AZ

General Provider Information

NPI Number : 1467099002
Entity Type Code : Individual
Provider Name (Legal Business Name) : DONNA SHANELLE HOPKINSON RN, LMT
Provider Business Mailing Address
First Line : 3301 E THOMAS RD STE A
Second Line :
City : PHOENIX
State : AZ
Zip : 85018-7302
Country : US
Telephone Number : 480-567-0236
Fax Number :
Provider Business Practice Location Address
First Line : 3301 E THOMAS RD STE A
Second Line :
City : PHOENIX
State : AZ
Zip : 85018-7302
Country : US
Telephone Number : 480-567-0236
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/03/2019
Last Update Date : 12/03/2019

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