Provider Demographics
NPI:1447082417
Name:HOPSON, KYRA Y (CHW,PRC, DOULA)
Entity type:Individual
Prefix:MISS
First Name:KYRA
Middle Name:Y
Last Name:HOPSON
Suffix:
Gender:F
Credentials:CHW,PRC, DOULA
Other - Prefix:MS
Other - First Name:KYRA
Other - Middle Name:1
Other - Last Name:HOPSON 1 .
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CHW, PRC, DOULA
Mailing Address - Street 1:215 OSBORN BLVD APT 102
Mailing Address - Street 2:
Mailing Address - City:SAULT SAINTE MARIE
Mailing Address - State:MI
Mailing Address - Zip Code:49783-1816
Mailing Address - Country:US
Mailing Address - Phone:906-203-7089
Mailing Address - Fax:
Practice Address - Street 1:508 ASHMUN ST # 1201
Practice Address - Street 2:
Practice Address - City:SAULT SAINTE MARIE
Practice Address - State:MI
Practice Address - Zip Code:49783-1976
Practice Address - Country:US
Practice Address - Phone:906-203-7089
Practice Address - Fax:906-635-1566
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-17
Last Update Date:2024-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI652404374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula