Provider Demographics
NPI:1285730085
Name:HOOSE, BARBARA M (MSN FNP-C)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:M
Last Name:HOOSE
Suffix:
Gender:F
Credentials:MSN FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20185 E OCOTILLO RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85242-7663
Mailing Address - Country:US
Mailing Address - Phone:480-888-2010
Mailing Address - Fax:480-888-2074
Practice Address - Street 1:20185 E OCOTILLO RD
Practice Address - Street 2:SUITE 104
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85242-7663
Practice Address - Country:US
Practice Address - Phone:480-888-2010
Practice Address - Fax:480-888-2074
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP2470363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ237244Medicaid
AZQ73454Medicare PIN