Provider Demographics
NPI:1861498511
Name:VAN HOOSER, LYNN A (NP)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:A
Last Name:VAN HOOSER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2434 S 7TH ST
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79605-3149
Mailing Address - Country:US
Mailing Address - Phone:325-437-4005
Mailing Address - Fax:325-437-4007
Practice Address - Street 1:2434 S 7TH ST
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79605-3149
Practice Address - Country:US
Practice Address - Phone:325-437-4005
Practice Address - Fax:325-437-4007
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX240215363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXS63792Medicare UPIN
TXNP0342Medicare ID - Type Unspecified