Healthcare Provider Details

I. General information

NPI: 1992610984
Provider Name (Legal Business Name): CUITNA M HOFFMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MR. DANIEL I OLOWOBI

II. Dates (important events)

Enumeration Date: 08/15/2026
Last Update Date: 08/15/2026
Certification Date: 08/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5843 SHARKEY RD
CHARLESTON MS
38921-9159
US

IV. Provider business mailing address

5843 SHARKEY RD
CHARLESTON MS
38921-9159
US

V. Phone/Fax

Practice location:
  • Phone: 317-728-3421
  • Fax:
Mailing address:
  • Phone: 317-728-3421
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number1000674
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: