Healthcare Provider Details

I. General information

NPI: 1891619102
Provider Name (Legal Business Name): KELLY HOFFMEIER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

818 EDGEWATER DR
POLK CITY IA
50226-2240
US

IV. Provider business mailing address

818 EDGEWATER DR
POLK CITY IA
50226-2240
US

V. Phone/Fax

Practice location:
  • Phone: 515-975-7865
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number00523
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: