Provider Demographics
NPI:1104333111
Name:HOOPER, SARAH MARIE (RN)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:MARIE
Last Name:HOOPER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:MARIE
Other - Last Name:PARKKONEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:7373W RIVERVIEW DR
Mailing Address - Street 2:
Mailing Address - City:MANISTIQUE
Mailing Address - State:MI
Mailing Address - Zip Code:49854-8801
Mailing Address - Country:US
Mailing Address - Phone:906-458-1189
Mailing Address - Fax:
Practice Address - Street 1:7373W RIVERVIEW DR
Practice Address - Street 2:
Practice Address - City:MANISTIQUE
Practice Address - State:MI
Practice Address - Zip Code:49854-8801
Practice Address - Country:US
Practice Address - Phone:906-458-1189
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-29
Last Update Date:2018-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704324124163WP0200X, 251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No163WP0200XNursing Service ProvidersRegistered NursePediatrics