Provider Demographics
NPI:1265259758
Name:HOOVER, PAMELA SUE
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:SUE
Last Name:HOOVER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11880 STATE ROUTE 41
Mailing Address - Street 2:
Mailing Address - City:SOUTH SOLON
Mailing Address - State:OH
Mailing Address - Zip Code:43153-9774
Mailing Address - Country:US
Mailing Address - Phone:740-505-8320
Mailing Address - Fax:
Practice Address - Street 1:11880 STATE ROUTE 41
Practice Address - Street 2:
Practice Address - City:SOUTH SOLON
Practice Address - State:OH
Practice Address - Zip Code:43153-9774
Practice Address - Country:US
Practice Address - Phone:740-505-8320
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-25
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No172A00000XOther Service ProvidersDriver