Provider Demographics
NPI:1407210198
Name:HOOKER, LISA MARIE (MSN, PMHNP)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:MARIE
Last Name:HOOKER
Suffix:
Gender:F
Credentials:MSN, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DANSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14437-1709
Mailing Address - Country:US
Mailing Address - Phone:585-335-4316
Mailing Address - Fax:585-335-3577
Practice Address - Street 1:1 MAIN ST
Practice Address - Street 2:
Practice Address - City:DANSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14437-1709
Practice Address - Country:US
Practice Address - Phone:585-335-4316
Practice Address - Fax:585-335-3577
Is Sole Proprietor?:No
Enumeration Date:2016-04-08
Last Update Date:2016-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY402011363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health