Healthcare Provider Details

I. General information

NPI: 1609523927
Provider Name (Legal Business Name): BRIAN HOF
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2022
Last Update Date: 03/07/2022
Certification Date: 03/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

334 N CHERRY ST
RED CLOUD NE
68970-2246
US

IV. Provider business mailing address

334 N CHERRY ST
RED CLOUD NE
68970-2246
US

V. Phone/Fax

Practice location:
  • Phone: 402-746-3413
  • Fax:
Mailing address:
  • Phone: 402-746-3413
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number2014002299
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: