1962909325 NPI number — MRS. TIFFANIE NICOLE HOOVER APN

Table of content: MRS. TIFFANIE NICOLE HOOVER APN (NPI 1962909325)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962909325 NPI number — MRS. TIFFANIE NICOLE HOOVER APN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HOOVER
Provider First Name:
TIFFANIE
Provider Middle Name:
NICOLE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
APN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MORGAN
Provider Other First Name:
TIFFANIE
Provider Other Middle Name:
NICOLE
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1962909325
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/05/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5180 CROWTHER LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ALAMOSA
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
81101-8719
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
719-580-0279
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
SLV HEALTH
Provider Second Line Business Practice Location Address:
106 BLANCA AVE
Provider Business Practice Location Address City Name:
ALAMOSA
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
81101
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
719-589-2511
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/11/2018

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  APN.0993583-NP , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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