Healthcare Provider Details

I. General information

NPI: 1831974492
Provider Name (Legal Business Name): ALEXIS HOFSTETTER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2023
Last Update Date: 05/06/2025
Certification Date: 05/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6515 GRAND TETON PLZ STE 220
MADISON WI
53719-1048
US

IV. Provider business mailing address

6408 BRIDGE RD APT 567
MONONA WI
53713-1833
US

V. Phone/Fax

Practice location:
  • Phone: 608-713-9898
  • Fax:
Mailing address:
  • Phone: 608-692-7059
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number759323
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: