MEDICARE: MRS. LINDA MAE HOFFMANN RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WH0200X	Home Health Registered Nurse	0260028329	VT

General Provider Information

NPI Number	:	1215139837
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LINDA MAE HOFFMANN RN

Provider Business Mailing Address
First Line	:	3402 CALENDAR BROOK RD
Second Line	:
City	:	SUTTON
State	:	VT
Zip	:	05867
Country	:	US
Telephone Number	:	802-467-3514
Fax Number	:

Provider Business Practice Location Address
First Line	:	149 S BAILEY HAZEN RD
Second Line	:	HEATH & GRANT NELSON
City	:	E RYEGATE
State	:	VT
Zip	:	05042
Country	:	US
Telephone Number	:	802-584-4679
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/05/2007
Last Update Date	:	07/08/2007

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