Healthcare Provider Details

I. General information

NPI: 1114669389
Provider Name (Legal Business Name): BECKY ANN HOFMEISTER-TIMBLIN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/08/2022
Last Update Date: 04/08/2022
Certification Date: 04/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 VETERANS DR
MINNEAPOLIS MN
55417-2309
US

IV. Provider business mailing address

W197 410TH AVE
PLUM CITY WI
54761-8541
US

V. Phone/Fax

Practice location:
  • Phone: 612-725-2000
  • Fax:
Mailing address:
  • Phone: 651-260-3832
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License NumberR131363-1
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: