Provider Demographics
NPI:1720720253
Name:HOOPES, LYNDEE ANN
Entity Type:Individual
Prefix:
First Name:LYNDEE
Middle Name:ANN
Last Name:HOOPES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1266 S 45TH E
Mailing Address - Street 2:
Mailing Address - City:IDAHO FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83401-5927
Mailing Address - Country:US
Mailing Address - Phone:208-501-3146
Mailing Address - Fax:
Practice Address - Street 1:1266 S 45TH E
Practice Address - Street 2:
Practice Address - City:IDAHO FALLS
Practice Address - State:ID
Practice Address - Zip Code:83401-5927
Practice Address - Country:US
Practice Address - Phone:208-501-3146
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-13
Last Update Date:2022-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program