Provider Demographics
NPI:1306411301
Name:HOOKER, MICHELLE DARLENE (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:DARLENE
Last Name:HOOKER
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76 W POINT WASHINGTON CT
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32459-5584
Mailing Address - Country:US
Mailing Address - Phone:850-217-4044
Mailing Address - Fax:
Practice Address - Street 1:76 W POINT WASHINGTON CT
Practice Address - Street 2:
Practice Address - City:SANTA ROSA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32459-5584
Practice Address - Country:US
Practice Address - Phone:850-217-4044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-21
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11012431363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily