Healthcare Provider Details

I. General information

NPI: 1144315763
Provider Name (Legal Business Name): TERESA A. HOFFMANN FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 06/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4881 NE GOODVIEW CIR
LEES SUMMIT MO
64064-1996
US

IV. Provider business mailing address

9200 INDIAN CREEK PKWY BLDG. 9, STE. 300
OVERLAND PARK KS
66210-2036
US

V. Phone/Fax

Practice location:
  • Phone: 913-574-2350
  • Fax: 913-574-2413
Mailing address:
  • Phone: 913-574-2800
  • Fax: 913-574-2336

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number45410
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number145651
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number145651
License Number StateMO
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number14-86097-102
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: