Healthcare Provider Details

I. General information

NPI: 1174035711
Provider Name (Legal Business Name): JACQUELIN HOFHEINS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2017
Last Update Date: 11/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 CASTLECREST DR
SPRING CREEK NV
89815-6706
US

IV. Provider business mailing address

515 CASTLECREST DR
SPRING CREEK NV
89815-6706
US

V. Phone/Fax

Practice location:
  • Phone: 775-397-3376
  • Fax:
Mailing address:
  • Phone: 775-397-3376
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN21488
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: