Healthcare Provider Details

I. General information

NPI: 1912970286
Provider Name (Legal Business Name): LISA N HOFFMAN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2006
Last Update Date: 09/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1470 MEDICAL PKWY SUITE 160
CARSON CITY NV
89703-4648
US

IV. Provider business mailing address

PO BOX 4390
CARSON CITY NV
89702-4390
US

V. Phone/Fax

Practice location:
  • Phone: 775-445-7650
  • Fax: 775-882-4206
Mailing address:
  • Phone: 775-445-7650
  • Fax: 775-882-4218

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SM0705X
TaxonomyMedical-Surgical Clinical Nurse Specialist
License NumberAPN000803
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: