Healthcare Provider Details

I. General information

NPI: 1336358217
Provider Name (Legal Business Name): LINDSEY MARIE HOFFMANN P.A.-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1055 N 300 W STE 303
PROVO UT
84604-3373
US

IV. Provider business mailing address

1055 N 300 W STE 303
PROVO UT
84604-3373
US

V. Phone/Fax

Practice location:
  • Phone: 801-357-7377
  • Fax: 807-357-7378
Mailing address:
  • Phone: 801-357-7377
  • Fax: 807-357-7378

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number6542073-1206
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: