Healthcare Provider Details

I. General information

NPI: 1639442957
Provider Name (Legal Business Name): ASHLEY NICHOLE HOOPER DVM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/16/2012
Last Update Date: 11/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20610 N CAVE CREEK RD
PHOENIX AZ
85024-4414
US

IV. Provider business mailing address

20610 N CAVE CREEK RD
PHOENIX AZ
85024-4414
US

V. Phone/Fax

Practice location:
  • Phone: 602-697-4694
  • Fax: 602-992-3755
Mailing address:
  • Phone: 602-697-4694
  • Fax: 602-992-3755

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174M00000X
TaxonomyVeterinarian
License NumberVM9862
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code174M00000X
TaxonomyVeterinarian
License Number6164
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: