Healthcare Provider Details

I. General information

NPI: 1679728786
Provider Name (Legal Business Name): ADAM GREGORY HOHMAN FNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/18/2008
Last Update Date: 12/23/2019
Certification Date: 12/23/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1245 WASHINGTON AVE
DETROIT LAKES MN
56501-3905
US

IV. Provider business mailing address

209 2ND STREET SE P.O. BOX 279
BARNESVILLE MN
56514
US

V. Phone/Fax

Practice location:
  • Phone: 218-846-2000
  • Fax: 218-846-2114
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR187315-5
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: