Healthcare Provider Details

I. General information

NPI: 1538604723
Provider Name (Legal Business Name): EDITH S. HOFF R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/27/2016
Last Update Date: 12/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1323 BIA ROUTE 4 FT. THOMPSON INDIAN HEALTH SERVICE CENTER
FORT THOMPSON SD
57339
US

IV. Provider business mailing address

PO BOX 200, 1323 BIA ROUTE 4 FT. THOMPSON INDIAN HEALTH SERVICE CENTER
FORT THOMPSON SD
57339
US

V. Phone/Fax

Practice location:
  • Phone: 605-245-1586
  • Fax: 605-245-2384
Mailing address:
  • Phone: 605-245-1586
  • Fax: 605-245-2384

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberR028904
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: