Provider Demographics
NPI:1417582842
Name:HOFFMEISTER, KELSEY STROM (APRN)
Entity type:Individual
Prefix:MRS
First Name:KELSEY
Middle Name:STROM
Last Name:HOFFMEISTER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 S LOWRY ST
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:OK
Mailing Address - Zip Code:74074-3627
Mailing Address - Country:US
Mailing Address - Phone:405-614-1590
Mailing Address - Fax:
Practice Address - Street 1:1323 W 6TH AVE STE 201
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:OK
Practice Address - Zip Code:74074-4306
Practice Address - Country:US
Practice Address - Phone:404-533-3010
Practice Address - Fax:405-533-5314
Is Sole Proprietor?:No
Enumeration Date:2020-03-05
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK107399363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily