Healthcare Provider Details

I. General information

NPI: 1457877524
Provider Name (Legal Business Name): ALLYSON HOFFMAN CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALLYSON KITCHENS

II. Dates (important events)

Enumeration Date: 08/20/2017
Last Update Date: 11/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 EUCLID AVE
CLEVELAND OH
44195-0001
US

IV. Provider business mailing address

11820 EDGEWATER DR APT T11
LAKEWOOD OH
44107-1797
US

V. Phone/Fax

Practice location:
  • Phone: 770-377-9964
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAPRN.CNP.021563
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: