Provider Demographics
NPI:1225004161
Name:HOFFMANN, JULIE (NP)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:HOFFMANN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3701 KATZ DR
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IA
Mailing Address - Zip Code:52302-3871
Mailing Address - Country:US
Mailing Address - Phone:319-373-3022
Mailing Address - Fax:319-373-0208
Practice Address - Street 1:3701 KATZ DR
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IA
Practice Address - Zip Code:52302-3871
Practice Address - Country:US
Practice Address - Phone:319-373-3022
Practice Address - Fax:319-373-0208
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA5201010207Q00000X
IA102942363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0475301Medicaid
IA0475301Medicaid
IAP74351Medicare UPIN