Provider Demographics
NPI:1285864892
Name:HOOPER, NIKI G (RN)
Entity Type:Individual
Prefix:
First Name:NIKI
Middle Name:G
Last Name:HOOPER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:287 MCLAWS CIR
Mailing Address - Street 2:SUITE 2
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23185-5872
Mailing Address - Country:US
Mailing Address - Phone:757-220-9008
Mailing Address - Fax:757-220-9027
Practice Address - Street 1:287 MCLAWS CIR
Practice Address - Street 2:SUITE 2
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185-5872
Practice Address - Country:US
Practice Address - Phone:757-220-9008
Practice Address - Fax:757-220-9027
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-16
Last Update Date:2009-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001082288163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA306229OtherFEDERAL ANTHEM