Healthcare Provider Details

I. General information

NPI: 1851060941
Provider Name (Legal Business Name): CASSANDRA LEIGH HOFFMANN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2021
Last Update Date: 03/30/2023
Certification Date: 03/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 29TH ST S
GREAT FALLS MT
59405-5315
US

IV. Provider business mailing address

4321 41ST AVE
COLUMBUS NE
68601-2131
US

V. Phone/Fax

Practice location:
  • Phone: 406-771-3107
  • Fax: 406-771-3021
Mailing address:
  • Phone: 402-562-7500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number53-80036-061
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number114038
License Number StateNE
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberNUR-APRN-LIC-212585
License Number StateMT
# 4
Primary TaxonomyN
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License Number53-80036-061
License Number StateKS
# 5
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberNUR-APRN-LIC-212585
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: