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NPI Code Detail

MEDICARE: AMANDA ANN HOOSE C-NP

MEDICARE: AMANDA ANN HOOSE C-NP
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
1363LF0000XFamily Nurse PractitionerCOA.12792-NPOH

General Provider Information

NPI Number : 1871878199
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA ANN HOOSE C-NP
Provider Business Mailing Address
First Line : 20455 LORAIN ROAD
Second Line : SUITE T01
City : FAIRVIEW PARK
State : OH
Zip : 44126-3495
Country : US
Telephone Number : 440-799-4224
Fax Number : 440-799-4228
Provider Business Practice Location Address
First Line : 9050 N CHURCH DR
Second Line :
City : PARMA HEIGHTS
State : OH
Zip : 44130-4701
Country : US
Telephone Number : 440-292-0226
Fax Number : 440-292-0228
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2011
Last Update Date : 01/19/2017

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