Provider Demographics
NPI:1689487431
Name:HOOK, KRISTEN NICOLE
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:NICOLE
Last Name:HOOK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:706 W OSAGE ST
Mailing Address - Street 2:
Mailing Address - City:CLEVER
Mailing Address - State:MO
Mailing Address - Zip Code:65631-7806
Mailing Address - Country:US
Mailing Address - Phone:417-849-3414
Mailing Address - Fax:
Practice Address - Street 1:1235 E CHEROKEE ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-2203
Practice Address - Country:US
Practice Address - Phone:417-820-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-27
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO1232523363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant