Provider Demographics
NPI:1427332865
Name:HOFFMAN, HEATHER JO (LPN)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:JO
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5491 US HIGHWAY 42
Mailing Address - Street 2:
Mailing Address - City:MOUNT GILEAD
Mailing Address - State:OH
Mailing Address - Zip Code:43338-9693
Mailing Address - Country:US
Mailing Address - Phone:740-816-3287
Mailing Address - Fax:
Practice Address - Street 1:5491 US HIGHWAY 42
Practice Address - Street 2:
Practice Address - City:MOUNT GILEAD
Practice Address - State:OH
Practice Address - Zip Code:43338-9693
Practice Address - Country:US
Practice Address - Phone:740-816-3287
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-04
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH145527164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse