Provider Demographics
NPI:1033550801
Name:HOOPER, KATHARINE J (FNP)
Entity Type:Individual
Prefix:MISS
First Name:KATHARINE
Middle Name:J
Last Name:HOOPER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:11 SOUTH RD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06032-2483
Mailing Address - Country:US
Mailing Address - Phone:860-674-0578
Mailing Address - Fax:860-674-0024
Practice Address - Street 1:11 SOUTH RD
Practice Address - Street 2:SUITE 250
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06032-2483
Practice Address - Country:US
Practice Address - Phone:860-674-0578
Practice Address - Fax:860-674-0024
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-09
Last Update Date:2018-09-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MARN2269721363LF0000X
CT006530363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily