Healthcare Provider Details

I. General information

NPI: 1518398320
Provider Name (Legal Business Name): KATHERENE R HOFSTETTER APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2013
Last Update Date: 07/30/2025
Certification Date: 07/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 DORRANCE ST STE 700
PROVIDENCE RI
02903-2014
US

IV. Provider business mailing address

10 DORRANCE ST STE 700
PROVIDENCE RI
02903-2014
US

V. Phone/Fax

Practice location:
  • Phone: 888-731-8994
  • Fax:
Mailing address:
  • Phone: 888-731-8994
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number5629
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPRN00766
License Number StateRI
# 3
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberAPRN00766
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: