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NPI Code Detail

MEDICARE: THERESA M HOFFACKER MAED

MEDICARE: THERESA M HOFFACKER MAED
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1376876862
Entity Type Code : Individual
Provider Name (Legal Business Name) : THERESA M HOFFACKER MAED
Provider Business Mailing Address
First Line : 1690 S TELSHOR BLVD
Second Line :
City : LAS CRUCES
State : NM
Zip : 88011-4889
Country : US
Telephone Number : 575-556-8470
Fax Number :
Provider Business Practice Location Address
First Line : 1690 S TELSHOR BLVD
Second Line :
City : LAS CRUCES
State : NM
Zip : 88011-4889
Country : US
Telephone Number : 575-556-8470
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/15/2009
Last Update Date : 09/15/2009

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Directions to “ THERESA M HOFFACKER MAED” Practice Location

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