MEDICARE: PATRICIA C HOOVER CRNA

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	367500000X	Certified Registered Nurse Anesthetist	RN247786L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	500041279	OTHER	PA	CAPITAL BLUE CROSS

General Provider Information

NPI Number	:	1417914573
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA C HOOVER CRNA

Provider Business Mailing Address
First Line	:	PO BOX 13579
Second Line	:
City	:	READING
State	:	PA
Zip	:	19612-3579
Country	:	US
Telephone Number	:	484-628-0799
Fax Number	:	484-334-7026

Provider Business Practice Location Address
First Line	:	6TH AVENUE & SPRUCE ST.
Second Line	:
City	:	WEST READING
State	:	PA
Zip	:	19611-1428
Country	:	US
Telephone Number	:	484-628-8269
Fax Number	:

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

Provider Enumeration Date	:	05/01/2006
Last Update Date	:	11/24/2014

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