Provider Demographics
NPI:1073749255
Name:HOFFARTH, BRIANNA LYNN (PT)
Entity Type:Individual
Prefix:MISS
First Name:BRIANNA
Middle Name:LYNN
Last Name:HOFFARTH
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 296
Mailing Address - Street 2:
Mailing Address - City:SARTELL
Mailing Address - State:MN
Mailing Address - Zip Code:56377-1977
Mailing Address - Country:US
Mailing Address - Phone:320-251-2600
Mailing Address - Fax:320-251-4763
Practice Address - Street 1:100 SOUTH 2ND STREET
Practice Address - Street 2:
Practice Address - City:SARTELL
Practice Address - State:MN
Practice Address - Zip Code:56377-1977
Practice Address - Country:US
Practice Address - Phone:320-251-2600
Practice Address - Fax:320-251-4763
Is Sole Proprietor?:No
Enumeration Date:2009-06-02
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN8298225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1219767OtherARAZ
MN64-09776OtherSELECT CARE
MN9823046OtherMEDICA
MN264M1NOOtherBLUE CROSS BLUE SHIELD OF MN
MN31T18INOtherCCS
MN64-09776OtherMEDICA
MN169318P539OtherUCARE
MN31T18INOtherBCBS
MN650002202Medicare PIN
MN31T18INOtherCCS
MN169318P539OtherUCARE
MN64-09776OtherMEDICA
MN9823046OtherMEDICA