Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | APRN.CNP.021702 | OH |
NPI | 1043728421 |
---|---|
Provider Name | Jessica Lea Hofer |
First Address | Hinckley, OH 44233-9786 |
Second Address | Cleveland, OH 44195 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/01/2018 |
Last Update Date | 18/01/2018 |