Healthcare Provider Details

I. General information

NPI: 1811305543
Provider Name (Legal Business Name): JOETTE HOFFMAN CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2014
Last Update Date: 07/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 MONTAGE MOUNTAIN RD
MOOSIC PA
18507-1782
US

IV. Provider business mailing address

135 LAFAYETTE AVE
PALMERTON PA
18071-1518
US

V. Phone/Fax

Practice location:
  • Phone: 570-346-3686
  • Fax: 570-558-6838
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberSP014020
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: