Provider Demographics
NPI:1073598215
Name:HOOVER, DIANE M (ARNP)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:M
Last Name:HOOVER
Suffix:
Gender:F
Credentials:ARNP
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Mailing Address - Street 1:202 10TH ST SE
Mailing Address - Street 2:SUITE 225
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52403-2404
Mailing Address - Country:US
Mailing Address - Phone:319-364-7101
Mailing Address - Fax:319-363-1993
Practice Address - Street 1:202 10TH ST SE
Practice Address - Street 2:SUITE 225
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52403-2404
Practice Address - Country:US
Practice Address - Phone:319-364-7101
Practice Address - Fax:319-363-1993
Is Sole Proprietor?:No
Enumeration Date:2005-12-09
Last Update Date:2013-05-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IAJ067653363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAIB1600016Medicare PIN
IAIB1599016Medicare PIN
IAIB1598016Medicare PIN