Provider Demographics
NPI:1588641872
Name:HOEK, JILL RENAE (PA)
Entity Type:Individual
Prefix:MRS
First Name:JILL
Middle Name:RENAE
Last Name:HOEK
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 2ND ST SE
Mailing Address - Street 2:
Mailing Address - City:DE SMET
Mailing Address - State:SD
Mailing Address - Zip Code:57231-0447
Mailing Address - Country:US
Mailing Address - Phone:605-854-3834
Mailing Address - Fax:605-854-3878
Practice Address - Street 1:115 2ND STREET SE
Practice Address - Street 2:
Practice Address - City:DE SMET
Practice Address - State:SD
Practice Address - Zip Code:57231-0463
Practice Address - Country:US
Practice Address - Phone:605-854-3834
Practice Address - Fax:605-854-3878
Is Sole Proprietor?:No
Enumeration Date:2005-12-28
Last Update Date:2010-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD0232SD363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD6820747Medicaid
SD6820744Medicaid
5078Medicare ID - Type Unspecified
SDS1639Medicare PIN
SD6820744Medicaid