Healthcare Provider Details

I. General information

NPI: 1275561995
Provider Name (Legal Business Name): MS. KATHLEEN MARY HOFFMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHLEEN MARY WEEKS R.N.,M.S.N.,C.S.

II. Dates (important events)

Enumeration Date: 06/29/2006
Last Update Date: 05/07/2024
Certification Date: 05/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 MAPLE ST STE 400
MARLBOROUGH MA
01752-3200
US

IV. Provider business mailing address

86 BALDWIN AVE
MARLBOROUGH MA
01752-1349
US

V. Phone/Fax

Practice location:
  • Phone: 774-420-8224
  • Fax:
Mailing address:
  • Phone: 508-251-0156
  • Fax: 508-303-0008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number183925PC
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: