Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 38151 | KY |
N | 2080P0204X | Pediatric Emergency Doctor | 38151 | KY |
NPI | 1013993740 |
---|---|
Provider Name | Jennifer Wright Hopkins |
First Address | Burkesville, KY 42717-1080 |
Second Address | Glasgow, KY 42141-3487 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/12/2005 |
Last Update Date | 09/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200386100 | (05) | IN |
64054836 | (05) | KY |
H65564 | (02) |