1447956453 NPI number — RACHEL SCARLET SKINNER HOPKINS MS, CRC

Table of content: DR. MARY LYNN PUCHALSKI DNP, APRN, CNS, NNP- (NPI 1235366402)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447956453 NPI number — RACHEL SCARLET SKINNER HOPKINS MS, CRC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HOPKINS
Provider First Name:
RACHEL
Provider Middle Name:
SCARLET SKINNER
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MS, CRC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SKINNER
Provider Other First Name:
RACHEL
Provider Other Middle Name:
SCARLET
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1447956453
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/01/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
325 SURREY PARK DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FAYETTEVILLE
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30215-2535
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
115 HABERSHAM DR STE C
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FAYETTEVILLE
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30214-7353
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
770-461-9944
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/01/2023

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101Y00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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