Provider Demographics
NPI:1669364659
Name:HOPKINS-HUNTLY, DESHERA S (CERT NURSING ASSIS)
Entity type:Individual
Prefix:
First Name:DESHERA
Middle Name:S
Last Name:HOPKINS-HUNTLY
Suffix:
Gender:F
Credentials:CERT NURSING ASSIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 WESTERN LN STE 9E
Mailing Address - Street 2:
Mailing Address - City:IRMO
Mailing Address - State:SC
Mailing Address - Zip Code:29063-7953
Mailing Address - Country:US
Mailing Address - Phone:839-295-9335
Mailing Address - Fax:
Practice Address - Street 1:401 WESTERN LN STE 9E
Practice Address - Street 2:
Practice Address - City:IRMO
Practice Address - State:SC
Practice Address - Zip Code:29063-7953
Practice Address - Country:US
Practice Address - Phone:839-295-9335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-16
Last Update Date:2025-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2431251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health