Healthcare Provider Details

I. General information

NPI: 1821051830
Provider Name (Legal Business Name): ELIZABETH A. HOOVER C.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELIZABETH A. NATHAN C.N.P.

II. Dates (important events)

Enumeration Date: 04/10/2006
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

455 SHAWNEE LN
CHILLICOTHEE OH
45601-4145
US

IV. Provider business mailing address

455 SHAWNEE LN
CHILLICOTHEE OH
45601-4145
US

V. Phone/Fax

Practice location:
  • Phone: 740-779-4888
  • Fax: 740-779-4898
Mailing address:
  • Phone: 740-779-4888
  • Fax: 740-779-4898

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number05681
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number05681
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: