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General NPI Number Information
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NPI Number | 1629078829
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Entity Type | Individual
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Provider Name | TINA NADINE HOOVER ADULT NURSE PRACTITI
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Gender | Female
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Dates
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Enumeration Date | 07/28/2005
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 900 E FLORENCE BLVD STE. H
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City | CASA GRANDE
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State | AZ
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Zip | 85222-4666
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Country | US
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Telephone | 520-836-4382
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Fax | 520-876-5794
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Provider Business Mailing Address
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Address Line | 609 E MANOR DR
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City | CASA GRANDE
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State | AZ
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Zip | 85222-2614
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Country | US
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Telephone | 520-423-1954
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Fax | 520-876-5794
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | RN022497
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License Number State | AZ
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