Provider Demographics
NPI:1790084689
Name:HOOKER, RHONDA (APRN)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:
Last Name:HOOKER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:RHONDA
Other - Middle Name:
Other - Last Name:DOLEN-HOOKER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:186 SUNSET PALMS DR UNIT 2A
Mailing Address - Street 2:
Mailing Address - City:CAMDENTON
Mailing Address - State:MO
Mailing Address - Zip Code:65020-7093
Mailing Address - Country:US
Mailing Address - Phone:217-899-8672
Mailing Address - Fax:573-317-1970
Practice Address - Street 1:409R W US HIGHWAY 54
Practice Address - Street 2:
Practice Address - City:CAMDENTON
Practice Address - State:MO
Practice Address - Zip Code:65020-6948
Practice Address - Country:US
Practice Address - Phone:573-317-9061
Practice Address - Fax:573-317-1970
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-18
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020004722363LP0808X
IL041232362163W00000X
MO2007005809163W00000X
MS901843363L00000X
IL209008693363LF0000X
MO201700006363LF0000X
FLAPRN11001998363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL329446672001Medicaid
IL329446672001Medicaid
IL522000023Medicare PIN