MEDICARE: JENNIFER NICOLE HOFFMAN FNP-C

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	363LF0000X	Family Nurse Practitioner	71015674A	IN
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1629800727
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER NICOLE HOFFMAN FNP-C

Provider Business Mailing Address
First Line	:	1116 MILLIS AVE STE 101
Second Line	:
City	:	BOONVILLE
State	:	IN
Zip	:	47601-2226
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1116 MILLIS AVE STE 101
Second Line	:
City	:	BOONVILLE
State	:	IN
Zip	:	47601-2226
Country	:	US
Telephone Number	:	812-897-7107
Fax Number	:

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

Provider Enumeration Date	:	08/16/2024
Last Update Date	:	01/13/2026

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