Healthcare Provider Details

I. General information

NPI: 1326062779
Provider Name (Legal Business Name): MICHELE G. HOFFMAN M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MICHELE G. TRIPP M.S.

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9200 W WISCONSIN AVE
MILWAUKEE WI
53226-3522
US

IV. Provider business mailing address

10000 W INNOVATION DR
MILWAUKEE WI
53226-4837
US

V. Phone/Fax

Practice location:
  • Phone: 414-805-3666
  • Fax:
Mailing address:
  • Phone: 414-456-5006
  • Fax: 414-456-6259

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number482
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: