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NPI Code Detail

MEDICARE: KYLIE NESTA HOOVER PMHNP

MEDICARE: KYLIE NESTA HOOVER PMHNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WP0808XPsychiatric/Mental Health Registered NurseRN713740PA
2363LP0808XPsychiatric/Mental Health Nurse Practitioner5020739NC

General Provider Information

NPI Number : 1669210589
Entity Type Code : Individual
Provider Name (Legal Business Name) : KYLIE NESTA HOOVER PMHNP
Provider Business Mailing Address
First Line : 3801 BARRETT DR
Second Line :
City : RALEIGH
State : NC
Zip : 27609-7224
Country : US
Telephone Number : 919-870-8409
Fax Number : 877-622-8953
Provider Business Practice Location Address
First Line : 3801 BARRETT DR
Second Line :
City : RALEIGH
State : NC
Zip : 27609-7224
Country : US
Telephone Number : 919-870-8409
Fax Number : 877-622-8953
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/16/2024
Last Update Date : 10/24/2025

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