MEDICARE: BRANDON JOHN HOFLAND NURSE PRACTITIONER

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
1	363L00000X	Nurse Practitioner	CP003133	SD
2	363L00000X	Nurse Practitioner	268949	MT
3	363L00000X	Nurse Practitioner	A177592	IA
4	363LF0000X	Family Nurse Practitioner	115395	NE

General Provider Information

NPI Number	:	1528820123
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRANDON JOHN HOFLAND NURSE PRACTITIONER

Provider Business Mailing Address
First Line	:	421 2ND AVE NE
Second Line	:
City	:	SIOUX CENTER
State	:	IA
Zip	:	51250-1705
Country	:	US
Telephone Number	:	712-449-5460
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 GOLD CIR STE 200
Second Line	:
City	:	DAKOTA DUNES
State	:	SD
Zip	:	57049-5505
Country	:	US
Telephone Number	:	605-273-3399
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/29/2024
Last Update Date	:	11/11/2025

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