Healthcare Provider Details

I. General information

NPI: 1447071808
Provider Name (Legal Business Name): DEBRA JEAN HOOK RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2024
Last Update Date: 10/18/2024
Certification Date: 10/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4532 EMBERCREST LN
FORT WORTH TX
76123-4000
US

IV. Provider business mailing address

4532 EMBERCREST LN
FORT WORTH TX
76123-4000
US

V. Phone/Fax

Practice location:
  • Phone: 614-648-2788
  • Fax:
Mailing address:
  • Phone: 614-648-2788
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1097255
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: