Individual
MRS. MILDRED JAYNE HOOVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
10628 PARK ROAD, CHARLOTTE, NC 28210
(704) 667-1000
(704) 667-0409
Mailing address
11619 FOGGY BANK LN, CHARLOTTE, NC 28214-7133
(704) 394-7550
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
035920
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8051801
—
NC
Enumeration date
07/06/2006
Last updated
07/08/2007
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