Healthcare Provider Details

I. General information

NPI: 1043429673
Provider Name (Legal Business Name): STEPHANIE KAY HOFMANN PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1702 HILLCREST DR
BELLEVUE NE
68005-3652
US

IV. Provider business mailing address

7113 S 33RD ST
BELLEVUE NE
68147-1343
US

V. Phone/Fax

Practice location:
  • Phone: 402-291-8500
  • Fax: 402-682-4256
Mailing address:
  • Phone: 402-731-0797
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number328
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: