Provider Demographics
NPI:1215714803
Name:HOOKS, CHIQUITA TYANNA
Entity type:Individual
Prefix:
First Name:CHIQUITA
Middle Name:TYANNA
Last Name:HOOKS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 IRISH LN UNIT A
Mailing Address - Street 2:
Mailing Address - City:MILLEDGEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31061-1622
Mailing Address - Country:US
Mailing Address - Phone:678-672-8428
Mailing Address - Fax:
Practice Address - Street 1:141 IRISH LN UNIT A
Practice Address - Street 2:
Practice Address - City:MILLEDGEVILLE
Practice Address - State:GA
Practice Address - Zip Code:31061-1622
Practice Address - Country:US
Practice Address - Phone:678-672-8428
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-08
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4008082376K00000X
WV107567376K00000X
MECNA102018376K00000X
OK320748310823376K00000X
GACN0000027740376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide