Healthcare Provider Details

I. General information

NPI: 1902051709
Provider Name (Legal Business Name): HEATHER JO HOFFMAN-SEIFERT CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/20/2008
Last Update Date: 08/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 LAKESIDE AVE. #1000
CLEVELAND OH
44114
US

IV. Provider business mailing address

1001 LAKESIDE AVE. #1000
CLEVELAND OH
44114
US

V. Phone/Fax

Practice location:
  • Phone: 419-516-7438
  • Fax: 855-210-3123
Mailing address:
  • Phone: 419-516-7438
  • Fax: 855-210-3123

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704256575
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: