Provider Demographics
NPI:1386824233
Name:HOFFMAN, FELICIA LOREN (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:FELICIA
Middle Name:LOREN
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:FELICIA
Other - Middle Name:LOREN
Other - Last Name:DENNIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:2500 HOSPITAL BLVD STE 280
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-4918
Mailing Address - Country:US
Mailing Address - Phone:770-754-0787
Mailing Address - Fax:770-755-5890
Practice Address - Street 1:2500 HOSPITAL BLVD STE 280
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-4918
Practice Address - Country:US
Practice Address - Phone:770-754-0787
Practice Address - Fax:770-755-5890
Is Sole Proprietor?:No
Enumeration Date:2007-11-08
Last Update Date:2021-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA004715363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA202I972603Medicare PIN