Provider Demographics
NPI:1285235929
Name:ACTIVATE FAMILY HEALTH, PLLC
Entity type:Organization
Organization Name:ACTIVATE FAMILY HEALTH, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:HOPSON
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, FNP-C
Authorized Official - Phone:936-647-5380
Mailing Address - Street 1:203 E DAVIS ST STE F-1026
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77301-3159
Mailing Address - Country:US
Mailing Address - Phone:936-647-5380
Mailing Address - Fax:
Practice Address - Street 1:203 E DAVIS ST STE F-1026
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77301-3159
Practice Address - Country:US
Practice Address - Phone:936-647-5380
Practice Address - Fax:936-703-5900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-07
Last Update Date:2020-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty