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General NPI Number Information
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NPI Number | 1134741366
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Entity Type | Individual
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Provider Name | MICAH ELIZABETH HOFMANN MS, LAT, ATC
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Gender | Female
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Dates
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Enumeration Date | 05/11/2020
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Last Update Date | 12/23/2025
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Provider Practice Location Address
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Address Line | 8072 NORMANDY DR
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City | FT RILEY
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State | KS
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Zip | 66442-7069
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Country | US
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Telephone | 785-239-3627
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Fax |
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Provider Business Mailing Address
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Address Line | 26509 THUNDER RD APT 1
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City | FT RILEY
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State | KS
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Zip | 66442-3550
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Country | US
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Telephone | 913-360-9523
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 24-01805
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 0000001697
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License Number State | TN
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