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General NPI Number Information
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NPI Number | 1730417205
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Entity Type | Organization
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Legal Business Name | JANE HOOVER FNP
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Dates
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Enumeration Date | 11/22/2009
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Last Update Date | 11/22/2009
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Provider Practice Location Address
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Address Line | 710 SUPERIOR ST SUITE B
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City | SANDPOINT
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State | ID
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Zip | 83864-1684
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Country | US
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Telephone | 208-265-2225
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Fax | 208-265-2229
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Provider Business Mailing Address
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Address Line | 1083 ROBINSON DR
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City | PRIEST RIVER
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State | ID
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Zip | 83856-9473
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Country | US
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Telephone | 208-448-0790
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Fax |
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Authorized Official
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Title or Position | FNP
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Name | MS. JANE ELLEN HOOVER
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Credential | MSN FNP
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Telephone | 208-448-0790
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | NP-779A
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License Number State | ID
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