Provider Demographics
NPI:1992172662
Name:HOOVER, SHERRIE LYNN (AGACNP)
Entity type:Individual
Prefix:MS
First Name:SHERRIE
Middle Name:LYNN
Last Name:HOOVER
Suffix:
Gender:F
Credentials:AGACNP
Other - Prefix:MRS
Other - First Name:SHERRIE
Other - Middle Name:LYNN
Other - Last Name:SHEPHERD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:3800 S OCEAN DR STE 209
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33019-2915
Mailing Address - Country:US
Mailing Address - Phone:305-466-9988
Mailing Address - Fax:305-466-9989
Practice Address - Street 1:26 VAN HORNE AVE # SNF
Practice Address - Street 2:
Practice Address - City:TYBEE ISLAND
Practice Address - State:GA
Practice Address - Zip Code:31328-9780
Practice Address - Country:US
Practice Address - Phone:305-466-9988
Practice Address - Fax:305-466-9989
Is Sole Proprietor?:No
Enumeration Date:2015-08-28
Last Update Date:2020-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN206554163W00000X, 163WW0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No163WW0000XNursing Service ProvidersRegistered NurseWound Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
GARN206554OtherADVANCED PRACTICE - NP
MD2019058630OtherAGACNP CERTIFICATION
GARN206554OtherREGISTERED PROF NURS