Provider Demographics
NPI:1336611797
Name:HOOVER, MERRILL ELIZABETH (MSN,FNP-BC)
Entity Type:Individual
Prefix:
First Name:MERRILL
Middle Name:ELIZABETH
Last Name:HOOVER
Suffix:
Gender:F
Credentials:MSN,FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23153 N RD
Mailing Address - Street 2:
Mailing Address - City:FOWLER
Mailing Address - State:KS
Mailing Address - Zip Code:67844-9204
Mailing Address - Country:US
Mailing Address - Phone:816-804-7230
Mailing Address - Fax:
Practice Address - Street 1:510 E CARTHAGE ST
Practice Address - Street 2:
Practice Address - City:MEADE
Practice Address - State:KS
Practice Address - Zip Code:67864-6401
Practice Address - Country:US
Practice Address - Phone:620-873-2112
Practice Address - Fax:620-873-5669
Is Sole Proprietor?:No
Enumeration Date:2018-12-26
Last Update Date:2018-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-78515-052363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily