1841201639 NPI number — MRS. PATRICIA JEAN HOFFMAN CRNP

Table of content: MRS. PATRICIA JEAN HOFFMAN CRNP (NPI 1841201639)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841201639 NPI number — MRS. PATRICIA JEAN HOFFMAN CRNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HOFFMAN
Provider First Name:
PATRICIA
Provider Middle Name:
JEAN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
CRNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FERRARA
Provider Other First Name:
PATRICIA
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
CRNP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1841201639
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/17/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 64208
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BALTIMORE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21264-4208
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
443-828-0442
Provider Business Mailing Address Fax Number:
703-289-1414

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5755 CEDAR LN
Provider Second Line Business Practice Location Address:
HCGH NICU
Provider Business Practice Location Address City Name:
COLUMBIA
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21044-2912
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-740-7557
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/10/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LN0000X , with the licence number:  R111606 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 891550400 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".