Provider Demographics
NPI:1164415006
Name:HOFFMAN, MELINDA K (RN CFNP)
Entity Type:Individual
Prefix:MRS
First Name:MELINDA
Middle Name:K
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:RN CFNP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:113 PLEASANT VALLEY DR STE 210
Mailing Address - Street 2:
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78006-5683
Mailing Address - Country:US
Mailing Address - Phone:830-267-4575
Mailing Address - Fax:830-267-4575
Practice Address - Street 1:113 PLEASANT VALLEY DR STE 210
Practice Address - Street 2:
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78006-5683
Practice Address - Country:US
Practice Address - Phone:830-267-4575
Practice Address - Fax:830-267-4575
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-25
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP130662363LF0000X
IN71001866A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200941040Medicaid
IN000000552332OtherANTHEM
IN000000552332OtherANTHEM