Provider Demographics
NPI:1457349557
Name:HOOVER, JANE E (RN MSN FNP)
Entity Type:Individual
Prefix:MS
First Name:JANE
Middle Name:E
Last Name:HOOVER
Suffix:
Gender:F
Credentials:RN MSN FNP
Other - Prefix:
Other - First Name:JANE
Other - Middle Name:E
Other - Last Name:WORKMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN MSN FNP
Mailing Address - Street 1:1207 MICHIGAN ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:SANDPOINT
Mailing Address - State:ID
Mailing Address - Zip Code:83864-6608
Mailing Address - Country:US
Mailing Address - Phone:208-265-2221
Mailing Address - Fax:208-265-2229
Practice Address - Street 1:1207 MICHIGAN STREET
Practice Address - Street 2:SUITE C
Practice Address - City:SANDPOINT
Practice Address - State:ID
Practice Address - Zip Code:83864
Practice Address - Country:US
Practice Address - Phone:208-265-2221
Practice Address - Fax:208-265-2229
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-12
Last Update Date:2013-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00145168/AP3000619363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9366804Medicaid
0166054OtherL & I
8933341OtherL & I CRIME VICTIMS
S79369Medicare UPIN
8933341OtherL & I CRIME VICTIMS