Healthcare Provider Details

I. General information

NPI: 1215957683
Provider Name (Legal Business Name): JENNI HOFFMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 05/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 WASHINGTON AVE N SUITE 5000
MINNEAPOLIS MN
55401-1377
US

IV. Provider business mailing address

333 WASHINGTON AVE N SUITE 5000
MINNEAPOLIS MN
55401-1377
US

V. Phone/Fax

Practice location:
  • Phone: 612-659-7111
  • Fax:
Mailing address:
  • Phone: 612-659-7111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704235580
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: