Provider Demographics
NPI:1346491271
Name:HOFFMAN, LISA DIANE (COBB-MAIDEN) (RN)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:DIANE (COBB-MAIDEN)
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:COBB
Other - Last Name:BUGNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:91-1155 HOOMAHANA ST
Mailing Address - Street 2:
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706-4630
Mailing Address - Country:US
Mailing Address - Phone:808-685-0855
Mailing Address - Fax:
Practice Address - Street 1:91-2301 OLD FT WEAVER RD
Practice Address - Street 2:
Practice Address - City:EWA BEACH
Practice Address - State:HI
Practice Address - Zip Code:96706-3602
Practice Address - Country:US
Practice Address - Phone:808-671-8511
Practice Address - Fax:808-677-2570
Is Sole Proprietor?:No
Enumeration Date:2008-10-09
Last Update Date:2008-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIRN-63380163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health