Healthcare Provider Details

I. General information

NPI: 1538272224
Provider Name (Legal Business Name): KAREN MARIE HOFFMANN-DISTAD FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAREN MARIE HOFFMANN FNP

II. Dates (important events)

Enumeration Date: 08/16/2006
Last Update Date: 03/11/2021
Certification Date: 03/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1324 5TH ST N
NEW ULM MN
56073-1514
US

IV. Provider business mailing address

119 EAST 3RD AVE
FRANKLIN MN
55333
US

V. Phone/Fax

Practice location:
  • Phone: 507-233-1000
  • Fax:
Mailing address:
  • Phone: 507-557-2834
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR 1284773
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number0505
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: