NPI Code Details Logo

NPI 1154721868

NPI 1154721868 : CARRIE AMANDA WILKES-HOFFMEISTER FNP-BC, DCNP : FARMVILLE, VA

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1154721868
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    CARRIE AMANDA WILKES-HOFFMEISTER FNP-BC, DCNP
-----------------------------------------------------
    Gender               |    Female 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    08/29/2014
-----------------------------------------------------
    Last Update Date     |    12/03/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    300 E 3RD ST 
-----------------------------------------------------
    City                 |    FARMVILLE
-----------------------------------------------------
    State                |    VA
-----------------------------------------------------
    Zip                  |    23901-1510
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    434-607-4599
-----------------------------------------------------
    Fax                  |    434-363-4191
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    801 YORK ST 
-----------------------------------------------------
    City                 |    MANITOWOC
-----------------------------------------------------
    State                |    WI
-----------------------------------------------------
    Zip                  |    54220-4630
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    920-663-9008
-----------------------------------------------------
    Fax                  |    920-684-1439
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    363L00000X
-----------------------------------------------------
    Taxonomy Name        |    Nurse Practitioner
-----------------------------------------------------
    License Number       |    0017141658
-----------------------------------------------------
    License Number State |    VA
-----------------------------------------------------



                        

Copyright © 2007-2025 Data Labs Health. All rights reserved.