Healthcare Provider Details

I. General information

NPI: 1649154352
Provider Name (Legal Business Name): CARLA HOFER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2025
Last Update Date: 08/05/2025
Certification Date: 08/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3939 NORTHVIEW DR
STOW OH
44224-3313
US

IV. Provider business mailing address

3939 NORTHVIEW DR
STOW OH
44224-3313
US

V. Phone/Fax

Practice location:
  • Phone: 330-907-5076
  • Fax:
Mailing address:
  • Phone: 330-907-5076
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberRN.497440
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: