Provider Demographics
NPI:1215947064
Name:HOECKER, JACALYN ANN (CRNA)
Entity type:Individual
Prefix:
First Name:JACALYN
Middle Name:ANN
Last Name:HOECKER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:JACALYN
Other - Middle Name:ANN
Other - Last Name:STEINMETZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:920 E 1ST ST STE P-101
Mailing Address - Street 2:PAVILION SURGERY CENTER
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55805-2201
Mailing Address - Country:US
Mailing Address - Phone:218-279-6200
Mailing Address - Fax:218-279-6205
Practice Address - Street 1:920 E 1ST ST STE P-101
Practice Address - Street 2:PAVILION SURGERY CENTER
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55805-2201
Practice Address - Country:US
Practice Address - Phone:218-279-6200
Practice Address - Fax:218-279-6205
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2014-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR174981-0367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered