Healthcare Provider Details

I. General information

NPI: 1346732294
Provider Name (Legal Business Name): ASHLEY ELAINE HOFER CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ASHLEY ELAINE GLANZER

II. Dates (important events)

Enumeration Date: 06/05/2018
Last Update Date: 09/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

911 E 20TH ST STE 700
SIOUX FALLS SD
57105-1049
US

IV. Provider business mailing address

911 E 20TH ST STE 700
SIOUX FALLS SD
57105-1049
US

V. Phone/Fax

Practice location:
  • Phone: 605-334-0393
  • Fax: 605-334-6028
Mailing address:
  • Phone: 605-334-0393
  • Fax: 605-334-6028

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCP001448
License Number StateSD
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR044193
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: