Provider Demographics
NPI:1023622578
Name:HOOVER, JENNIFER (CERTIFIED PHARM TECH)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:HOOVER
Suffix:
Gender:F
Credentials:CERTIFIED PHARM TECH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1732 SW KENT PL
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66604-3638
Mailing Address - Country:US
Mailing Address - Phone:785-383-8841
Mailing Address - Fax:
Practice Address - Street 1:3630 SW WANAMAKER RD
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66614-4528
Practice Address - Country:US
Practice Address - Phone:785-228-5656
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-02
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS14-112160183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician