Provider Demographics
NPI:1275780231
Name:HOFMANN, PRUDENCE OLIVIA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:PRUDENCE
Middle Name:OLIVIA
Last Name:HOFMANN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 427 BOX 1093
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09630-0011
Mailing Address - Country:US
Mailing Address - Phone:314-636-9418
Mailing Address - Fax:
Practice Address - Street 1:UNIT 31403 BOX 13
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09630-1403
Practice Address - Country:US
Practice Address - Phone:314-636-9418
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-21
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX46349183500000X, 1835P1200X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy