1649219809 NPI number — DR. JEANNE M. HOPPLE PHD, ANP-BC, FNP-C

Table of content: DR. JEANNE M. HOPPLE PHD, ANP-BC, FNP-C (NPI 1649219809)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649219809 NPI number — DR. JEANNE M. HOPPLE PHD, ANP-BC, FNP-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HOPPLE
Provider First Name:
JEANNE
Provider Middle Name:
M.
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHD, ANP-BC, FNP-C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HOPPLE
Provider Other First Name:
JEANNE
Provider Other Middle Name:
M.
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
PHD, ANP-BC, FNP-C
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1649219809
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/10/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
THE HEART INSTITUTE OF EAST TEXAS, CROCKETT OFFICE
Provider Second Line Business Mailing Address:
951 E. LOOP 304
Provider Business Mailing Address City Name:
CROCKETT
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75835
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
936-545-9030
Provider Business Mailing Address Fax Number:
936-546-0107

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
THE HEART INSTITUTE OF EAST TEXAS, CROCKET
Provider Second Line Business Practice Location Address:
951 E. LOOP 304
Provider Business Practice Location Address City Name:
CROCKETT
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75835
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
936-545-9030
Provider Business Practice Location Address Fax Number:
936-546-0380
Provider Enumeration Date:
06/05/2006

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: 363L00000X , with the licence number:  ARNP935922 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: AP135355 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 302832100 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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