Healthcare Provider Details
I. General information
NPI: 1053751461
Provider Name (Legal Business Name): AMY ELIZABETH HOFFMAN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/28/2013
Last Update Date: 10/23/2025
Certification Date: 10/23/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
226 US HIGHWAY 20
MIDDLEBURY IN
46540-9713
US
IV. Provider business mailing address
226 US HIGHWAY 20
MIDDLEBURY IN
46540-9713
US
V. Phone/Fax
- Phone: 574-825-8068
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 71004514A |
| License Number State | IN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: