Healthcare Provider Details

I. General information

NPI: 1144979931
Provider Name (Legal Business Name): CINDY ANN HOFFMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2022
Last Update Date: 03/21/2022
Certification Date: 03/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 SALEM DR STE 2
OWENSBORO KY
42303-7758
US

IV. Provider business mailing address

3601 LEWIS LN
OWENSBORO KY
42301-6960
US

V. Phone/Fax

Practice location:
  • Phone: 270-686-6040
  • Fax:
Mailing address:
  • Phone: 270-314-5325
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number3014387
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: