Individual
KELLY HOOVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
825 N 90TH ST, OMAHA, NE 68114-2702
(402) 932-2248
Mailing address
2808 N 75TH ST, OMAHA, NE 68134-6861
(402) 932-2248
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1976
NE
Other
Enumeration date
01/26/2016
Last updated
01/26/2016
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