Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 0101-053613 | VA |
NPI | 1033188586 |
---|---|
Provider Name | Dr. Shelley Kae Hoover |
First Address | Henrico, VA 23294-4210 |
Second Address | Henrico, VA 23294-4210 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2006 |
Last Update Date | 04/04/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G65206 | (02) | VA |