Provider Demographics
NPI:1659972966
Name:HOOVEN, REBECCA L (PMHNP)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:L
Last Name:HOOVEN
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:L
Other - Last Name:SINGLETON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PMHNP
Mailing Address - Street 1:1167 SPRATLIN PARK DR
Mailing Address - Street 2:
Mailing Address - City:GRAY
Mailing Address - State:TN
Mailing Address - Zip Code:37615-6205
Mailing Address - Country:US
Mailing Address - Phone:423-467-3600
Mailing Address - Fax:423-467-3644
Practice Address - Street 1:208 E UNAKA AVE
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37601-4626
Practice Address - Country:US
Practice Address - Phone:423-926-0940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-03
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024184606363LP0808X
TN28242363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health