Healthcare Provider Details

I. General information

NPI: 1912900267
Provider Name (Legal Business Name): TALIA ANN HOFMANN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2005
Last Update Date: 10/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8550 W 38TH AVE STE 202
WHEAT RIDGE CO
80033-4342
US

IV. Provider business mailing address

8550 W 38TH AVE STE 202
WHEAT RIDGE CO
80033-4342
US

V. Phone/Fax

Practice location:
  • Phone: 303-940-1661
  • Fax: 303-431-8708
Mailing address:
  • Phone: 303-940-1661
  • Fax: 303-431-8708

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA1284
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: