Healthcare Provider Details

I. General information

NPI: 1528820123
Provider Name (Legal Business Name): BRANDON JOHN HOFLAND NURSE PRACTITIONER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2024
Last Update Date: 11/11/2025
Certification Date: 11/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 GOLD CIR STE 200
DAKOTA DUNES SD
57049-5505
US

IV. Provider business mailing address

421 2ND AVE NE
SIOUX CENTER IA
51250-1705
US

V. Phone/Fax

Practice location:
  • Phone: 605-273-3399
  • Fax:
Mailing address:
  • Phone: 712-449-5460
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberCP003133
License Number StateSD
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number268949
License Number StateMT
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberA177592
License Number StateIA
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number115395
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: