Provider Demographics
NPI:1679086367
Name:HOPE NP HOUSE CALL PRACTICE
Entity type:Organization
Organization Name:HOPE NP HOUSE CALL PRACTICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CNP
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:HUGHES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-710-1306
Mailing Address - Street 1:98 GRANDVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:OH
Mailing Address - Zip Code:45640-9090
Mailing Address - Country:US
Mailing Address - Phone:740-710-1306
Mailing Address - Fax:866-496-6040
Practice Address - Street 1:98 GRANDVIEW AVE
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:OH
Practice Address - Zip Code:45640-9090
Practice Address - Country:US
Practice Address - Phone:740-710-1306
Practice Address - Fax:866-496-6040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-16
Last Update Date:2017-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH12485207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty