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General NPI Number Information
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NPI Number | 1306490248
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Entity Type | Individual
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Provider Name | JACQUELYNN MARIE HOFFMAN APRN-CNP
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Gender | Female
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Dates
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Enumeration Date | 07/29/2019
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Last Update Date | 07/29/2019
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Provider Practice Location Address
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Address Line | 807 E WASHINGTON ST STE 220
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City | MEDINA
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State | OH
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Zip | 44256-3330
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Country | US
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Telephone | 330-536-3746
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Fax |
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Provider Business Mailing Address
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Address Line | 3593 MEDINA RD # 181
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City | MEDINA
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State | OH
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Zip | 44256-8182
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Country | US
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Telephone | 330-536-3746
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Fax | 330-267-4250
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN.CNP.025280
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License Number State | OH
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