Healthcare Provider Details

I. General information

NPI: 1922166479
Provider Name (Legal Business Name): KATHRYN S HOEFER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

LANDSTUHL REGIONAL MEDICAL CENTER CMR 402
APO AE
09180
DE

IV. Provider business mailing address

LANDSTUHL REGIONAL MEDICAL CENTER CMR 402
APO AE
09180
DE

V. Phone/Fax

Practice location:
  • Phone: 496371867570
  • Fax: 496371867266
Mailing address:
  • Phone: 496371867570
  • Fax: 496371867266

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code286500000X
TaxonomyMilitary Hospital
License NumberP4771
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: