Healthcare Provider Details

I. General information

NPI: 1013324003
Provider Name (Legal Business Name): REBECCA HOOPER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2014
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4241 JOHNNY CAKE RIDGE RD
EAGAN MN
55122-2235
US

IV. Provider business mailing address

6445 RICHFIELD PKWY
RICHFIELD MN
55423-6400
US

V. Phone/Fax

Practice location:
  • Phone: 612-819-6886
  • Fax:
Mailing address:
  • Phone: 612-819-6886
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number11643
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: