Healthcare Provider Details

I. General information

NPI: 1083894380
Provider Name (Legal Business Name): SUSAN E. HOFFMAN CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/05/2007
Last Update Date: 06/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

283 NIANTIC RD
BARTO PA
19504-9301
US

IV. Provider business mailing address

283 NIANTIC RD
BARTO PA
19504-9301
US

V. Phone/Fax

Practice location:
  • Phone: 610-845-3049
  • Fax:
Mailing address:
  • Phone: 610-845-3049
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN-323655-L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: