Provider Demographics
NPI:1164105649
Name:HOOVER, AMBER GRACE (FNP-C)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:GRACE
Last Name:HOOVER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1049 FELSPAR ST UNIT 3
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92109-2829
Mailing Address - Country:US
Mailing Address - Phone:619-851-8005
Mailing Address - Fax:
Practice Address - Street 1:1049 FELSPAR ST UNIT 3
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92109-2829
Practice Address - Country:US
Practice Address - Phone:619-851-8005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-10
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO95024147363L00000X
CA95024147163WH1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH1000XNursing Service ProvidersRegistered NurseHospice
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner