Provider Demographics
NPI:1235419920
Name:HOFFERT, KORI RAE (APNP)
Entity Type:Individual
Prefix:MRS
First Name:KORI
Middle Name:RAE
Last Name:HOFFERT
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:902 MCCALLIE AVE
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37403-2724
Mailing Address - Country:US
Mailing Address - Phone:423-664-4460
Mailing Address - Fax:423-648-5675
Practice Address - Street 1:941 SPRING CREEK RD
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37412-3909
Practice Address - Country:US
Practice Address - Phone:423-664-4460
Practice Address - Fax:423-648-5675
Is Sole Proprietor?:No
Enumeration Date:2011-08-25
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN16524363LN0000X
WI4473-33363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal