Healthcare Provider Details

I. General information

NPI: 1851800767
Provider Name (Legal Business Name): SONIA LEFREDA HOFFMAN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2017
Last Update Date: 03/23/2021
Certification Date: 03/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 MEMORIAL DR
DALTON GA
30720-2529
US

IV. Provider business mailing address

PO BOX 1168
DALTON GA
30722-1168
US

V. Phone/Fax

Practice location:
  • Phone: 706-272-6000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberRN222542
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: