Healthcare Provider Details

I. General information

NPI: 1730450123
Provider Name (Legal Business Name): HOLLI HOFFMAN CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/18/2012
Last Update Date: 01/09/2025
Certification Date: 01/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 S CEDAR CREST BLVD FL 2
ALLENTOWN PA
18103-6202
US

IV. Provider business mailing address

111 E LIBERTY ST
SYKESVILLE PA
15865-1103
US

V. Phone/Fax

Practice location:
  • Phone: 610-402-6164
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number81402
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN586063
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: