Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | ME71781 | FL |
NPI | 1063545226 |
---|---|
Provider Name | Patricia Sue Hoepner |
First Address | Grand Rapids, MI 49503-2560 |
Second Address | Reed City, MI 49677-8041 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2007 |
Last Update Date | 09/03/2021 |