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NPI Code Detail

MEDICARE: THERESA M HOFFOSS WHCNP

MEDICARE: THERESA M HOFFOSS WHCNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LW0102XWomen's Health Nurse PractitionerR161997-9MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1174593990
Entity Type Code : Individual
Provider Name (Legal Business Name) : THERESA M HOFFOSS WHCNP
Provider Business Mailing Address
First Line : 5124 39TH AVE S
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55417-1652
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2603 WHITE BEAR AVE N
Second Line :
City : MAPLEWOOD
State : MN
Zip : 55109-5110
Country : US
Telephone Number : 651-600-3035
Fax Number : 651-348-8783
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/24/2006
Last Update Date : 02/15/2018

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Directions to “ THERESA M HOFFOSS WHCNP” Practice Location

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