Healthcare Provider Details

I. General information

NPI: 1306710371
Provider Name (Legal Business Name): MAKAYLA JEAN HOFFMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2025
Last Update Date: 10/24/2025
Certification Date: 10/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 OVERLOOK TER
MADISON WI
53705-2254
US

IV. Provider business mailing address

1033 AUTUMN BLAZE CT
OREGON WI
53575-8912
US

V. Phone/Fax

Practice location:
  • Phone: 608-256-1901
  • Fax:
Mailing address:
  • Phone: 920-205-6203
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number135539-121
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: