Individual
SHANTA TAMIKA HOPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
1502 PARKVIEW AVE, ROCKFORD, IL 61107-1821
(815) 381-7250
(815) 381-7251
Mailing address
1502 PARKVIEW AVE, ROCKFORD, IL 61107-1821
(815) 381-7250
(815) 381-7251
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209016322
IL
Other
Enumeration date
10/02/2017
Last updated
02/14/2023
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