MEDICARE: MARY ANN HOOVER CRNP

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	363LF0000X	Family Nurse Practitioner	SP003752B	PA

General Provider Information

NPI Number	:	1477553873
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY ANN HOOVER CRNP

Provider Business Mailing Address
First Line	:	105 SOUTHFIELD CT
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15237-1274
Country	:	US
Telephone Number	:	412-364-2603
Fax Number	:	412-364-5591

Provider Business Practice Location Address
First Line	:	105 SOUTHFIELD CT
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15237-1274
Country	:	US
Telephone Number	:	412-364-2603
Fax Number	:	412-364-5591

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

Provider Enumeration Date	:	07/28/2005
Last Update Date	:	07/08/2007

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