Provider Demographics
NPI:1245301480
Name:HOOPER, KATHRYN A (FNP)
Entity type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:A
Last Name:HOOPER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13905-2524
Mailing Address - Country:US
Mailing Address - Phone:607-584-4465
Mailing Address - Fax:607-584-4480
Practice Address - Street 1:303 MAIN ST
Practice Address - Street 2:
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13905-2524
Practice Address - Country:US
Practice Address - Phone:607-584-4465
Practice Address - Fax:607-584-4480
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-10
Last Update Date:2009-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF330763363L00000X
NYF400884363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner