Healthcare Provider Details

I. General information

NPI: 1083545859
Provider Name (Legal Business Name): GLORIA SUE HOFFMAN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 NAVARRE PL STE 4410
SOUTH BEND IN
46601-1171
US

IV. Provider business mailing address

3245 HEALTH DR STE 100
GRANGER IN
46530-1380
US

V. Phone/Fax

Practice location:
  • Phone: 574-647-6370
  • Fax: 574-647-6373
Mailing address:
  • Phone: 574-647-2713
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71018417A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: