Healthcare Provider Details

I. General information

NPI: 1992484059
Provider Name (Legal Business Name): SYDNEY HOFFMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2023
Last Update Date: 07/17/2023
Certification Date: 07/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2117 S SILVERTHORNE AVE APT 110
SIOUX FALLS SD
57110-7703
US

IV. Provider business mailing address

2117 S SILVERTHORNE AVE APT 110
SIOUX FALLS SD
57110-7703
US

V. Phone/Fax

Practice location:
  • Phone: 605-951-7087
  • Fax:
Mailing address:
  • Phone: 605-951-7087
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR057866
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: