Healthcare Provider Details

I. General information

NPI: 1528549367
Provider Name (Legal Business Name): KATHRYN SUZANNE HOFFMAN RDN, LD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2018
Last Update Date: 11/06/2023
Certification Date: 11/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3720 NE TROON DR
LEES SUMMIT MO
64064-1988
US

IV. Provider business mailing address

12832 SAINT ANDREWS DR
KANSAS CITY MO
64145-1230
US

V. Phone/Fax

Practice location:
  • Phone: 515-537-4916
  • Fax:
Mailing address:
  • Phone: 515-537-4916
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number2058
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number2017036207
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: