Provider Demographics
NPI:1346236882
Name:HOEFT, KATY R (PA-C)
Entity type:Individual
Prefix:MS
First Name:KATY
Middle Name:R
Last Name:HOEFT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:KATY
Other - Middle Name:R
Other - Last Name:NANCE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:1200 N. EL DORADO PLACE
Mailing Address - Street 2:F-670
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85715-4637
Mailing Address - Country:US
Mailing Address - Phone:520-324-4774
Mailing Address - Fax:520-324-2567
Practice Address - Street 1:6452 E CARONDELET DR STE 100
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710-2262
Practice Address - Country:US
Practice Address - Phone:520-885-5300
Practice Address - Fax:520-885-5309
Is Sole Proprietor?:No
Enumeration Date:2005-09-20
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2863363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ961096Medicaid
AZS59756Medicare UPIN