1336396308 NPI number — DR. KRISTINE MARIE HOFFMAN DPM

Table of content: DR. KRISTINE MARIE HOFFMAN DPM (NPI 1336396308)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336396308 NPI number — DR. KRISTINE MARIE HOFFMAN DPM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HOFFMAN
Provider First Name:
KRISTINE
Provider Middle Name:
MARIE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DPM
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1336396308
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/25/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3000 CENTER GREEN DR
Provider Second Line Business Mailing Address:
SUITE 210
Provider Business Mailing Address City Name:
BOULDER
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80301-2364
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-443-8900
Provider Business Mailing Address Fax Number:
303-442-3140

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3000 CENTER GREEN DR
Provider Second Line Business Practice Location Address:
SUITE 210
Provider Business Practice Location Address City Name:
BOULDER
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80301-2364
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-443-8900
Provider Business Practice Location Address Fax Number:
303-442-3140
Provider Enumeration Date:
08/21/2008

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: 213ES0103X , with the licence number:  POD-681 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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