| Doctor Name: | MR. CHARLES DONOVAN HOOPER |
| NPI Number: | 1447661525 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | CRNP |
| License Number: | 1-077820 |
| Business Practice Address: | 28779 Nick Davis Rd. Limestone Correctional Facility Harvest, AL - 35749 |
| Business Phone Number: | 2562334600 |
| Business Fax Number: | 2562309417 |
| Mailing Address: | 28779 Nick Davis R.d., Limestone Correctional Facility HARVEST |
| State: | AL |
| Postal Code: | 35749 |
| Phone Number: | 2562334600 |
| Fax Number: | 2562309417 |
| NPI Enumeration Date: | 05/12/2014 |
| NPI Last Update Date: | 05/12/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2100X |
| License Number: | 1-077820 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Acute Care |
| Taxonomy Definition: | |