MEDICARE: SHELLY F HOOPER 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	C002637	AR

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00415238	OTHER	AR	RAILROAD MEDICARE

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	:	1497808166
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHELLY F HOOPER CRNA

Provider Business Mailing Address
First Line	:	4301 W MARKHAM ST # 783
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72205-7101
Country	:	US
Telephone Number	:	501-686-8000
Fax Number	:	501-526-5148

Provider Business Practice Location Address
First Line	:	10915 N RODNEY PARHAM RD STE F
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72212-4202
Country	:	US
Telephone Number	:	501-686-8000
Fax Number	:	501-526-5148

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

Provider Enumeration Date	:	01/18/2007
Last Update Date	:	08/01/2024

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Directions to “ SHELLY F HOOPER CRNA” Practice Location

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