Healthcare Provider Details

I. General information

NPI: 1003615048
Provider Name (Legal Business Name): ROSALYN MARIE HOFPAR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ROSALYN MARIE BRAY

II. Dates (important events)

Enumeration Date: 03/12/2025
Last Update Date: 03/12/2025
Certification Date: 03/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 N 89TH ST STE 202
OMAHA NE
68114-4072
US

IV. Provider business mailing address

341 N 44TH ST APT 709
LINCOLN NE
68503-3741
US

V. Phone/Fax

Practice location:
  • Phone: 402-502-5750
  • Fax:
Mailing address:
  • Phone: 402-446-0174
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number100367
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: