Healthcare Provider Details

I. General information

NPI: 1043643174
Provider Name (Legal Business Name): PATRICK M. HOFERER NP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2013
Last Update Date: 08/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5885 HARRISON AVE SUITE 2700
CINCINNATI OH
45248-1691
US

IV. Provider business mailing address

5885 HARRISON AVE SUITE 2700
CINCINNATI OH
45248-1691
US

V. Phone/Fax

Practice location:
  • Phone: 513-251-9900
  • Fax: 513-244-4130
Mailing address:
  • Phone: 513-251-9900
  • Fax: 513-244-4130

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberCOA. 14818-NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: