Healthcare Provider Details

I. General information

NPI: 1245878115
Provider Name (Legal Business Name): KURTIS MICHAEL HOEFLING APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2019
Last Update Date: 12/14/2019
Certification Date: 12/14/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 JAMES ST
VERDIGRE NE
68783-6149
US

IV. Provider business mailing address

401 JAMES ST
VERDIGRE NE
68783-6149
US

V. Phone/Fax

Practice location:
  • Phone: 402-668-2216
  • Fax:
Mailing address:
  • Phone: 402-668-2216
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2095
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number113047
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: