Provider Demographics
NPI:1134635188
Name:HOOVER, KATHRYN M (ARNP)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:M
Last Name:HOOVER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:M
Other - Last Name:HOOVER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5100 PRAIRIE PKWY STE 101
Mailing Address - Street 2:
Mailing Address - City:CEDAR FALLS
Mailing Address - State:IA
Mailing Address - Zip Code:50613-8155
Mailing Address - Country:US
Mailing Address - Phone:319-553-0828
Mailing Address - Fax:319-277-7548
Practice Address - Street 1:5100 PRAIRIE PKWY STE 101
Practice Address - Street 2:
Practice Address - City:CEDAR FALLS
Practice Address - State:IA
Practice Address - Zip Code:50613-8155
Practice Address - Country:US
Practice Address - Phone:319-553-0828
Practice Address - Fax:319-277-7548
Is Sole Proprietor?:No
Enumeration Date:2017-12-28
Last Update Date:2017-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA115842163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse