Healthcare Provider Details

I. General information

NPI: 1659954436
Provider Name (Legal Business Name): CAROLYN ASHLEY HOFFMAN APRN, NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2021
Last Update Date: 05/26/2022
Certification Date: 05/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1491 HEALTH CENTER PKWY
YUKON OK
73099-6492
US

IV. Provider business mailing address

1491 HEALTH CENTER PKWY
YUKON OK
73099-6492
US

V. Phone/Fax

Practice location:
  • Phone: 405-806-2200
  • Fax: 405-806-2207
Mailing address:
  • Phone: 405-421-6931
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number102055
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number206668
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: