Provider Demographics
NPI:1801534102
Name:HOOVER, AMBER B (PA-C)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:B
Last Name:HOOVER
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1509 GENESEE AVE NE
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44483-4137
Mailing Address - Country:US
Mailing Address - Phone:330-219-4158
Mailing Address - Fax:
Practice Address - Street 1:421 S HIGH ST
Practice Address - Street 2:
Practice Address - City:CORTLAND
Practice Address - State:OH
Practice Address - Zip Code:44410-1437
Practice Address - Country:US
Practice Address - Phone:330-485-0670
Practice Address - Fax:330-333-6600
Is Sole Proprietor?:No
Enumeration Date:2022-05-25
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.007516RX363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant