Healthcare Provider Details

I. General information

NPI: 1770428161
Provider Name (Legal Business Name): DOMINIQUE HOOVER DNP, APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1112 W 6TH ST STE 109
LAWRENCE KS
66044-2249
US

IV. Provider business mailing address

612 N WHITE DR
GARDNER KS
66030-1471
US

V. Phone/Fax

Practice location:
  • Phone: 785-840-9292
  • Fax: 785-505-5275
Mailing address:
  • Phone: 785-577-4309
  • Fax: 785-577-4309

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number85870
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: