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NPI Code Detail

MEDICARE: JESSE J HOFFMEYER CPNP

MEDICARE: JESSE J HOFFMEYER CPNP
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
1363LP0200XPediatric Nurse Practitioner13792TN
2363LP0200XPediatric Nurse Practitioner71003208AIN
3363LP0200XPediatric Nurse Practitioner4704284732MI

General Provider Information

NPI Number : 1467607622
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSE J HOFFMEYER CPNP
Provider Business Mailing Address
First Line : 50 INDUSTRIAL PARK RD
Second Line :
City : BANGOR
State : MI
Zip : 49013-1246
Country : US
Telephone Number : 269-427-7937
Fax Number : 269-427-5180
Provider Business Practice Location Address
First Line : 800 M 139
Second Line :
City : BENTON HARBOR
State : MI
Zip : 49022-3881
Country : US
Telephone Number : 269-927-5400
Fax Number : 269-927-5493
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/01/2008
Last Update Date : 12/28/2011

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Directions to “ JESSE J HOFFMEYER CPNP” Practice Location

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