=====================================================
General NPI Number Information
=====================================================
NPI Number | 1043795701
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CHRISTINA LYNN HOOVER
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/28/2018
-----------------------------------------------------
Last Update Date | 09/28/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3676 N HERMITAGE RD
-----------------------------------------------------
City | TRANSFER
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 16154-1852
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 330-726-0700
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 810 N MERCER ST
-----------------------------------------------------
City | NEW CASTLE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 16101-2335
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 724-202-3886
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 164W00000X
-----------------------------------------------------
Taxonomy Name | Licensed Practical Nurse
-----------------------------------------------------
License Number | PN106971L
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------