Healthcare Provider Details

I. General information

NPI: 1285815936
Provider Name (Legal Business Name): ANITA E HOFMANN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/23/2007
Last Update Date: 09/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4913 W RENO AVE
OKLAHOMA CITY OK
73127-6339
US

IV. Provider business mailing address

3980 DARRIL RD
EDMOND OK
73003
US

V. Phone/Fax

Practice location:
  • Phone: 405-948-4900
  • Fax: 405-948-4919
Mailing address:
  • Phone: 405-420-8947
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberD8524361
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: