Provider Demographics
NPI:1477920122
Name:HOOKS, JOHNNA GAYLE
Entity Type:Individual
Prefix:MRS
First Name:JOHNNA
Middle Name:GAYLE
Last Name:HOOKS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3279 N CONSTANCE DR
Mailing Address - Street 2:UNIT #1
Mailing Address - City:PRESCOTT VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:86314-8898
Mailing Address - Country:US
Mailing Address - Phone:979-446-1876
Mailing Address - Fax:928-759-4820
Practice Address - Street 1:5250 N STOVER DR
Practice Address - Street 2:
Practice Address - City:PRESCOTT VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:86314-3842
Practice Address - Country:US
Practice Address - Phone:928-759-4800
Practice Address - Fax:928-759-4820
Is Sole Proprietor?:No
Enumeration Date:2015-08-28
Last Update Date:2015-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX878554163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse