Provider Demographics
NPI:1235682402
Name:HOFFART, NICOLE (OTA)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:HOFFART
Suffix:
Gender:F
Credentials:OTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:507 S 10TH ST
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68701-5022
Mailing Address - Country:US
Mailing Address - Phone:402-750-4041
Mailing Address - Fax:
Practice Address - Street 1:600 E BENJAMIN AVE
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701-0830
Practice Address - Country:US
Practice Address - Phone:402-750-4041
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-25
Last Update Date:2016-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE946224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant