Provider Demographics
NPI:1366981151
Name:HOPPER, DAWN MARIE (APRN)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:MARIE
Last Name:HOPPER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 N CLIFTON ST
Mailing Address - Street 2:
Mailing Address - City:FORDYCE
Mailing Address - State:AR
Mailing Address - Zip Code:71742-3055
Mailing Address - Country:US
Mailing Address - Phone:870-890-4056
Mailing Address - Fax:870-890-4103
Practice Address - Street 1:300 N CLIFTON ST
Practice Address - Street 2:
Practice Address - City:FORDYCE
Practice Address - State:AR
Practice Address - Zip Code:71742-3055
Practice Address - Country:US
Practice Address - Phone:870-890-4056
Practice Address - Fax:870-890-4103
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-14
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA004994363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily