MEDICARE: SARAH HOFFMAN DNP, PMHNP-BC

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	218444-4408	UT
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	AP10367	AZ

General Provider Information

NPI Number	:	1598052375
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH HOFFMAN DNP, PMHNP-BC

Provider Business Mailing Address
First Line	:	2514 FREEDOM ST
Second Line	:
City	:	PERRY
State	:	UT
Zip	:	84302-4570
Country	:	US
Telephone Number	:	801-821-1560
Fax Number	:

Provider Business Practice Location Address
First Line	:	10439 S 51ST ST STE 100
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85044-5224
Country	:	US
Telephone Number	:	480-828-7023
Fax Number	:

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

Provider Enumeration Date	:	06/30/2011
Last Update Date	:	05/31/2022

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