Provider Demographics
NPI:1437206729
Name:HOOVER, BRENDA M (MA)
Entity Type:Individual
Prefix:MS
First Name:BRENDA
Middle Name:M
Last Name:HOOVER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MS
Other - First Name:BRENDA
Other - Middle Name:M
Other - Last Name:BERGMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:555 N 30TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68131-2136
Mailing Address - Country:US
Mailing Address - Phone:402-280-8100
Mailing Address - Fax:402-280-8103
Practice Address - Street 1:555 N 30TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68131-2136
Practice Address - Country:US
Practice Address - Phone:402-498-6540
Practice Address - Fax:402-498-6357
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2010-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE126231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1582932Medicaid
IA4582833Medicaid
IA7582833Medicaid
IA9582833Medicaid
IA3582833Medicaid
IA3582932Medicaid
IA5582833Medicaid
IA0582833Medicaid
IA2582833Medicaid
IA2582932Medicaid
NE36848OtherBCBS ENT
IA6582833Medicaid
IA0582932Medicaid
IA1582833Medicaid
NE36844OtherBCBS BT
IA8582833Medicaid
IA8582833Medicaid
IA1582932Medicaid