Healthcare Provider Details

I. General information

NPI: 1205337367
Provider Name (Legal Business Name): MELINDA HOHFELD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/23/2018
Last Update Date: 02/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4729 CAPE COD DR
WICHITA FALLS TX
76310-3024
US

IV. Provider business mailing address

4729 CAPE COD DR
WICHITA FALLS TX
76310-3024
US

V. Phone/Fax

Practice location:
  • Phone: 940-224-3739
  • Fax:
Mailing address:
  • Phone: 940-224-3739
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number305094
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: