Healthcare Provider Details

I. General information

NPI: 1285188607
Provider Name (Legal Business Name): AMY HOFFMANN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2016
Last Update Date: 08/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12000 W 110TH ST
OVERLAND PARK KS
66210-3910
US

IV. Provider business mailing address

UNIVERSITY OF KUMC DEPT OF OB GYN 3901 RAINBOW BLVD MS 2028
KANSAS CITY KS
66160-0001
US

V. Phone/Fax

Practice location:
  • Phone: 913-574-1418
  • Fax: 913-574-1437
Mailing address:
  • Phone: 913-574-1418
  • Fax: 913-574-1437

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number5377047051
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: