Healthcare Provider Details

I. General information

NPI: 1992372361
Provider Name (Legal Business Name): KATHERINE A HOFFMAN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2021
Last Update Date: 06/05/2021
Certification Date: 06/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4221 MALSBARY RD STE 102
BLUE ASH OH
45242-5521
US

IV. Provider business mailing address

3026 WINDING TRAILS DR
EDGEWOOD KY
41017-9624
US

V. Phone/Fax

Practice location:
  • Phone: 513-241-1811
  • Fax:
Mailing address:
  • Phone: 513-400-8495
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: