Provider Demographics
NPI:1245268135
Name:HOOPER, PRISCILLA GAIL (CRNP)
Entity type:Individual
Prefix:MS
First Name:PRISCILLA
Middle Name:GAIL
Last Name:HOOPER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:741 COLLINA DR
Mailing Address - Street 2:
Mailing Address - City:LEWISBERRY
Mailing Address - State:PA
Mailing Address - Zip Code:17339-9586
Mailing Address - Country:US
Mailing Address - Phone:717-938-5368
Mailing Address - Fax:
Practice Address - Street 1:741 COLLINA DR
Practice Address - Street 2:
Practice Address - City:LEWISBERRY
Practice Address - State:PA
Practice Address - Zip Code:17339-9586
Practice Address - Country:US
Practice Address - Phone:717-938-5368
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2009-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP004063363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA104858OtherJOHNS HOPKINS
PA500020406OtherRAILROAD MEDICARE
MD618533OtherCAREFIRST MD BCBS
PA104858OtherJOHNS HOPKINS
PAS52482Medicare UPIN