Provider Demographics
NPI:1619467883
Name:HOPPER, CAROLINE LUTZ (PAC)
Entity type:Individual
Prefix:MS
First Name:CAROLINE
Middle Name:LUTZ
Last Name:HOPPER
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:CAROLINE
Other - Middle Name:WALKER
Other - Last Name:LUTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PAC
Mailing Address - Street 1:191 POST RD W
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06880-4625
Mailing Address - Country:US
Mailing Address - Phone:860-545-9000
Mailing Address - Fax:
Practice Address - Street 1:191 POST RD W
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06880-4625
Practice Address - Country:US
Practice Address - Phone:860-545-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-14
Last Update Date:2025-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPA0005362208000000X
CT7171363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No208000000XAllopathic & Osteopathic PhysiciansPediatrics