Provider Demographics
NPI:1609683473
Name:HOPPER, SHAQUANA (LPN)
Entity type:Individual
Prefix:MS
First Name:SHAQUANA
Middle Name:
Last Name:HOPPER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2440
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71914-2440
Mailing Address - Country:US
Mailing Address - Phone:501-620-5525
Mailing Address - Fax:501-321-9828
Practice Address - Street 1:407 CARSON ST
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71901-6852
Practice Address - Country:US
Practice Address - Phone:501-620-5525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-16
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR227772164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse