Provider Demographics
NPI:1811924632
Name:HOPEWELL, JANET LYNN (RD, CDE)
Entity type:Individual
Prefix:MRS
First Name:JANET
Middle Name:LYNN
Last Name:HOPEWELL
Suffix:
Gender:F
Credentials:RD, CDE
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 159
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49501-0159
Mailing Address - Country:US
Mailing Address - Phone:616-252-7975
Mailing Address - Fax:616-252-0975
Practice Address - Street 1:1919 BOSTON ST SE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49506-4160
Practice Address - Country:US
Practice Address - Phone:616-252-7975
Practice Address - Fax:616-252-0975
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
R365946133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2203083337082Medicare PIN