Provider Demographics
NPI:1437780483
Name:HOOPER, ELIZABETH DAVIS (CNP)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:DAVIS
Last Name:HOOPER
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1539
Mailing Address - Street 2:
Mailing Address - City:WALKER
Mailing Address - State:LA
Mailing Address - Zip Code:70785-1539
Mailing Address - Country:US
Mailing Address - Phone:225-243-4109
Mailing Address - Fax:225-952-9075
Practice Address - Street 1:1939 PATTERSON ST STE 102
Practice Address - Street 2:
Practice Address - City:GUNTERSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35976-2017
Practice Address - Country:US
Practice Address - Phone:256-486-9596
Practice Address - Fax:256-486-9599
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-29
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALF01200681363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily