Basic Information
Provider Information
NPI: 1013932524
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HOVIS
FirstName: SHIRLEY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: CRNA
OtherOrganizationName:  
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Mailing Information
Address1: 1860 PENNSYLVANIA AVE
Address2: STE 145 NORTHBAY NEONATOLOGY ASSOCIATES INC
City: FAIRFIELD
State: CA
PostalCode: 945333590
CountryCode: US
TelephoneNumber: 8882700340
FaxNumber: 8882700331
Practice Location
Address1: 300 HOSPITAL DR
Address2: SUTTER SOLANO MEDICAL CENTER
City: VALLEJO
State: CA
PostalCode: 945892574
CountryCode: US
TelephoneNumber: 7075545226
FaxNumber: 7075545102
Other Information
ProviderEnumerationDate: 07/13/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
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AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000XRN 325132CAX Nursing Service ProvidersRegistered Nurse 
367500000XNA 539CAX Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


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