Healthcare Provider Details

I. General information

NPI: 1427515147
Provider Name (Legal Business Name): MICHELLE ELIZABETH HOFFMAN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MICHELLE ELIZABETH BROWN PA-C

II. Dates (important events)

Enumeration Date: 02/28/2019
Last Update Date: 09/22/2022
Certification Date: 09/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

960 MOUNT OLIVE RD
GARDENDALE AL
35071-4655
US

IV. Provider business mailing address

PO BOX 55310
BIRMINGHAM AL
35255-5310
US

V. Phone/Fax

Practice location:
  • Phone: 205-263-0952
  • Fax:
Mailing address:
  • Phone: 205-731-9701
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA.1432
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA.1432
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: