Gwendolyn Marie Hootman, LVN

Key facts

NPI

1619090263

Entity type

Individual (NPI type 1)

Primary specialty

Licensed Vocational Nurse 164X00000X

License

VN198693 (CA)

Practice address

2689 Sierra Highway
Box 1359
Rosamond, CA 93560

Phone

(661) 256-7208

Fax

(661) 256-7209

NPI assigned

Apr 9, 2007

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619090263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 FAIRWIND AVE",
            "city": "ROSAMOND",
            "state": "CA",
            "postal_code": "935606633",
            "telephone_number": "661-256-8180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2689 SIERRA HIGHWAY",
            "address_2": "BOX 1359",
            "city": "ROSAMOND",
            "state": "CA",
            "postal_code": "93560",
            "telephone_number": "661-256-7208",
            "fax_number": "661-256-7209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOOTMAN",
        "first_name": "GWENDOLYN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "LVN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "VN198693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Rosamond, CA · Licensed Vocational Nurse in California