Healthcare Provider Details

I. General information

NPI: 1699357210
Provider Name (Legal Business Name): KAYTIE L HOFMANN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAYTIE L CRANNEY

II. Dates (important events)

Enumeration Date: 04/23/2021
Last Update Date: 11/06/2025
Certification Date: 11/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

605 OAK ST
BIG RAPIDS MI
49307-2048
US

IV. Provider business mailing address

100 MICHIGAN ST NE MC 845
GRAND RAPIDS MI
49503-2560
US

V. Phone/Fax

Practice location:
  • Phone: 231-592-4270
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number4704372354
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number4704372354
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: