Provider Demographics
NPI:1215101001
Name:HOFFMAN, MARY LOUISE (FNP)
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:LOUISE
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1509
Mailing Address - Street 2:
Mailing Address - City:KAUNAKAKAI
Mailing Address - State:HI
Mailing Address - Zip Code:96748-1509
Mailing Address - Country:US
Mailing Address - Phone:808-553-4368
Mailing Address - Fax:888-388-2307
Practice Address - Street 1:107B ALA MALAMA ST
Practice Address - Street 2:
Practice Address - City:KAUNAKAKAI
Practice Address - State:HI
Practice Address - Zip Code:96748
Practice Address - Country:US
Practice Address - Phone:808-553-4368
Practice Address - Fax:888-388-2307
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-14
Last Update Date:2014-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI865363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily