Healthcare Provider Details

I. General information

NPI: 1336448257
Provider Name (Legal Business Name): JENNIFER DAWN HOFFMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/17/2011
Last Update Date: 04/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1545 AUGUST LN
BRIGHTON CO
80601-3507
US

IV. Provider business mailing address

1545 AUGUST LN
BRIGHTON CO
80601-3507
US

V. Phone/Fax

Practice location:
  • Phone: 307-220-7535
  • Fax:
Mailing address:
  • Phone: 307-220-7535
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: