Healthcare Provider Details

I. General information

NPI: 1265764666
Provider Name (Legal Business Name): HOPE ELIZABETH QAMOOS CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/10/2010
Last Update Date: 01/30/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

875 BLAKE WILBUR DR
PALO ALTO CA
94304-2205
US

IV. Provider business mailing address

1257 LAKESIDE DR 1227
SUNNYVALE CA
94085-4054
US

V. Phone/Fax

Practice location:
  • Phone: 650-498-6004
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number209007964
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number21929
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: