Provider Demographics
NPI:1285841320
Name:HOFER, CARRIE P (NP)
Entity Type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:P
Last Name:HOFER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MRS
Other - First Name:CARRIE
Other - Middle Name:PUTNAM
Other - Last Name:HOFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:75 BEEKMAN ST
Mailing Address - Street 2:
Mailing Address - City:PLATTSBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12901-1438
Mailing Address - Country:US
Mailing Address - Phone:518-562-7305
Mailing Address - Fax:518-562-7568
Practice Address - Street 1:75 BEEKMAN ST
Practice Address - Street 2:
Practice Address - City:PLATTSBURGH
Practice Address - State:NY
Practice Address - Zip Code:12901-1438
Practice Address - Country:US
Practice Address - Phone:518-562-7305
Practice Address - Fax:518-562-7568
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2017-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF301380-1363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health