Provider Demographics
NPI:1285685354
Name:HOFSCHULZ, LISA C (NP)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:C
Last Name:HOFSCHULZ
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 1:5445 PARK CENTRAL CT
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109-6004
Mailing Address - Country:US
Mailing Address - Phone:239-464-6066
Mailing Address - Fax:800-398-9787
Practice Address - Street 1:5445 PARK CENTRAL CT
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109-6004
Practice Address - Country:US
Practice Address - Phone:800-838-3841
Practice Address - Fax:800-398-9787
Is Sole Proprietor?:No
Enumeration Date:2006-05-13
Last Update Date:2018-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9220669363LA2200X
WI2330669363LA2200X
GARN180033363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2138212OtherHIGHMARK BCBS