Healthcare Provider Details

I. General information

NPI: 1477280204
Provider Name (Legal Business Name): NADINE O HOFMEISTER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/02/2022
Last Update Date: 08/02/2022
Certification Date: 08/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7575 COCKRILL BEND BLVD
NASHVILLE TN
37209-1056
US

IV. Provider business mailing address

210 BEDROCK DR
WHITE HOUSE TN
37188-9564
US

V. Phone/Fax

Practice location:
  • Phone: 615-350-4973
  • Fax:
Mailing address:
  • Phone: 301-518-5368
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number3594
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: