Provider Demographics
NPI:1104028281
Name:HOOVLER, SUSAN C (ARNP)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:C
Last Name:HOOVLER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:C
Other - Last Name:FITZ-WILLIAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP-C
Mailing Address - Street 1:33 WALKER ST
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04732-3429
Mailing Address - Country:US
Mailing Address - Phone:207-945-5247
Mailing Address - Fax:
Practice Address - Street 1:33 WALKER ST
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:ME
Practice Address - Zip Code:04732-3429
Practice Address - Country:US
Practice Address - Phone:207-827-6128
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-01
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP821072164W00000X
MECNP81562363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME1104028281Medicaid