Individual
STACY JILL HOOVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN/FNP-C
Contact information
Practice address
1 WELLNESS BLVD STE 202, IRMO, SC 29063-2873
(803) 749-1111
(803) 749-0050
Mailing address
5608 SUNSET BLVD, LEXINGTON, SC 29072-2728
(803) 957-5322
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
21391
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21391
APRN LICENSE
SC
05
—
NP4819
—
SC
Enumeration date
10/24/2017
Last updated
07/25/2023
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