Provider Demographics
NPI:1336834936
Name:HOOVER, JESSICA L (SPECIALIST)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:L
Last Name:HOOVER
Suffix:
Gender:F
Credentials:SPECIALIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 HOSPITAL AVE
Mailing Address - Street 2:
Mailing Address - City:DU BOIS
Mailing Address - State:PA
Mailing Address - Zip Code:15801-1440
Mailing Address - Country:US
Mailing Address - Phone:814-375-6379
Mailing Address - Fax:814-375-9320
Practice Address - Street 1:635 MAPLE AVENUE
Practice Address - Street 2:
Practice Address - City:DU BOIS
Practice Address - State:PA
Practice Address - Zip Code:15801-2376
Practice Address - Country:US
Practice Address - Phone:814-299-3733
Practice Address - Fax:814-372-2880
Is Sole Proprietor?:No
Enumeration Date:2023-04-10
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist