Healthcare Provider Details

I. General information

NPI: 1154187722
Provider Name (Legal Business Name): KARI HOFFIUS PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KARI HOFFIUS PMHNP

II. Dates (important events)

Enumeration Date: 02/22/2024
Last Update Date: 02/22/2024
Certification Date: 02/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4467 CASCADE RD SE
GRAND RAPIDS MI
49546-3776
US

IV. Provider business mailing address

15746 WILLOWS DR
SPRING LAKE MI
49456-1145
US

V. Phone/Fax

Practice location:
  • Phone: 616-481-3784
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number4704340363
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: