Healthcare Provider Details

I. General information

NPI: 1942739917
Provider Name (Legal Business Name): JUDITH MARIE HOFFER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4725 PARKWICK DR
COLUMBUS OH
43228-6401
US

IV. Provider business mailing address

4725 PARKWICK DR
COLUMBUS OH
43228-6401
US

V. Phone/Fax

Practice location:
  • Phone: 614-655-3354
  • Fax: 614-317-4692
Mailing address:
  • Phone: 614-655-3354
  • Fax: 614-317-4692

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN158857
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: