Healthcare Provider Details

I. General information

NPI: 1649047564
Provider Name (Legal Business Name): JENNIFER HOFFART
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2023
Last Update Date: 10/07/2024
Certification Date: 10/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 W 46TH ST STE 208
KEARNEY NE
68847-8348
US

IV. Provider business mailing address

124 W 46TH ST STE 208
KEARNEY NE
68847-8348
US

V. Phone/Fax

Practice location:
  • Phone: 308-238-1821
  • Fax:
Mailing address:
  • Phone: 308-238-1821
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number14055
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: