Provider Demographics
NPI:1164883443
Name:HOOVER, HOLLY (CRNP, AGNP, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:
Last Name:HOOVER
Suffix:
Gender:F
Credentials:CRNP, AGNP, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14100 MCMULLEN HWY SW
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-5777
Mailing Address - Country:US
Mailing Address - Phone:301-729-7570
Mailing Address - Fax:301-729-7580
Practice Address - Street 1:14100 MCMULLEN HWY SW
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-5777
Practice Address - Country:US
Practice Address - Phone:301-729-7570
Practice Address - Fax:301-729-7580
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-14
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR153391207QA0505X, 207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine