Healthcare Provider Details

I. General information

NPI: 1669612164
Provider Name (Legal Business Name): LYNETTE LOUISE HOFFMAN MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/24/2009
Last Update Date: 02/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

167 KAPAA ST
HILO HI
96720-1619
US

IV. Provider business mailing address

167 KAPAA ST
HILO HI
96720-1619
US

V. Phone/Fax

Practice location:
  • Phone: 808-961-0630
  • Fax: 808-961-0630
Mailing address:
  • Phone: 808-961-0630
  • Fax: 808-961-0630

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN56715
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: