Healthcare Provider Details

I. General information

NPI: 1730140641
Provider Name (Legal Business Name): KATHLEEN HOFFLAND NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2006
Last Update Date: 04/18/2022
Certification Date: 04/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6315 QUARRY VISTA DR
FITCHBURG WI
53719-9101
US

IV. Provider business mailing address

6315 QUARRY VISTA DR
FITCHBURG WI
53719-9101
US

V. Phone/Fax

Practice location:
  • Phone: 608-345-0599
  • Fax: 608-265-0977
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number1326
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: