Provider Demographics
NPI:1164758728
Name:HOFF, ANDREA MARTHA (PA-C)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:MARTHA
Last Name:HOFF
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:905 S. FIESTA AVENUE
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:AZ
Mailing Address - Zip Code:85344
Mailing Address - Country:US
Mailing Address - Phone:928-669-2225
Mailing Address - Fax:928-669-6751
Practice Address - Street 1:905 S. FIESTA AVENUE
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:AZ
Practice Address - Zip Code:85344
Practice Address - Country:US
Practice Address - Phone:928-669-2225
Practice Address - Fax:928-669-6751
Is Sole Proprietor?:No
Enumeration Date:2009-11-02
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4478363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ4478OtherSTATE LICENSE
AZZP03006701Medicaid
AZZP03006701Medicaid