Healthcare Provider Details

I. General information

NPI: 1801284286
Provider Name (Legal Business Name): CARLA HOOVER AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/07/2015
Last Update Date: 09/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 HENRY CLAY BLVD
LEXINGTON KY
40502-1024
US

IV. Provider business mailing address

350 HENRY CLAY BLVD
LEXINGTON KY
40502-1024
US

V. Phone/Fax

Practice location:
  • Phone: 859-268-4545
  • Fax: 859-269-1857
Mailing address:
  • Phone: 859-268-4545
  • Fax: 859-269-1857

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number0141
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number0429
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: