Individual ProviderStacy HopperNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address3009 N Ballas Rd Ste 142a, Saint Louis, MO 63131-2322(314) 993-4949(314) 803-8026PECOS EnrollmentBased on the most recent information from CMS, provider Stacy Hopper does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1295126506Provider TypeIndividualFull NameHopper, StacyGenderFemaleSole ProprietorNoEnumeration Date2/9/2015Last Updated2/9/2015Contact InformationPractice LocationPractice Address3009 N Ballas Rd Ste 142a, Saint Louis, MO 63131-2322Phone(314) 993-4949FaxUnlisted FaxMailing LocationMailing Address2510 Silver Lake Estates Dr, Pacific, MO 63069-5572Phone(314) 803-8026FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363L00000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense2014042321MissouriCode363LA2200XDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense2014042321Missouri