Healthcare Provider Details

I. General information

NPI: 1114210754
Provider Name (Legal Business Name): JULIE ANN HOOK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2011
Last Update Date: 05/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 9TH AVE W
ALEXANDRIA MN
56308-2221
US

IV. Provider business mailing address

1401 SUGAR SAND WAY NW
ALEXANDRIA MN
56308-4705
US

V. Phone/Fax

Practice location:
  • Phone: 320-763-3912
  • Fax:
Mailing address:
  • Phone: 320-808-6082
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberL 69029-0
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: