Individual
IRENE T HOOVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
2200 RANDALLIA DR, FORT WAYNE, IN 46805-4638
(260) 344-4035
(260) 969-9272
Mailing address
6435 W JEFFERSON BLVD PMB 109, FORT WAYNE, IN 46804-6203
(260) 344-4035
(260) 969-9272
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
71001646A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200511080
—
IN
Enumeration date
07/10/2006
Last updated
07/22/2020
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