Healthcare Provider Details

I. General information

NPI: 1285108670
Provider Name (Legal Business Name): CRYSTAL LYNN HOFFMAN HOME HEALTH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/18/2019
Last Update Date: 11/01/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3255 CARDINGTON RD
MARION OH
43302-8439
US

IV. Provider business mailing address

3255 CARDINGTON RD
MARION OH
43302-8439
US

V. Phone/Fax

Practice location:
  • Phone: 740-361-3924
  • Fax:
Mailing address:
  • Phone: 740-361-3924
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: