MEDICARE: CHRISTINA LYNN HOOVER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	164W00000X	Licensed Practical Nurse	PN106971L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043795701
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA LYNN HOOVER

Provider Business Mailing Address
First Line	:	810 N MERCER ST
Second Line	:
City	:	NEW CASTLE
State	:	PA
Zip	:	16101-2335
Country	:	US
Telephone Number	:	724-202-3886
Fax Number	:

Provider Business Practice Location Address
First Line	:	3676 N HERMITAGE RD
Second Line	:
City	:	TRANSFER
State	:	PA
Zip	:	16154-1852
Country	:	US
Telephone Number	:	330-726-0700
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/28/2018
Last Update Date	:	09/28/2018

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