Healthcare Provider Details

I. General information

NPI: 1982144572
Provider Name (Legal Business Name): ANN HOFECKER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2017
Last Update Date: 03/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

429 MANOR DR SUITE 10
EBENSBURG PA
15931-4917
US

IV. Provider business mailing address

3681 ADMIRAL PEARY HWY
EBENSBURG PA
15931-3915
US

V. Phone/Fax

Practice location:
  • Phone: 814-472-6060
  • Fax: 814-472-1293
Mailing address:
  • Phone: 814-248-0748
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN511450L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: