Provider Demographics
NPI:1417445032
Name:HOFFMEISTER, AMBER (HIS)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:HOFFMEISTER
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3509 GATEWAY DR
Mailing Address - Street 2:
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54701-8795
Mailing Address - Country:US
Mailing Address - Phone:715-832-4327
Mailing Address - Fax:715-832-5290
Practice Address - Street 1:3509 GATEWAY DR
Practice Address - Street 2:
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54701-8795
Practice Address - Country:US
Practice Address - Phone:715-832-4327
Practice Address - Fax:715-832-5290
Is Sole Proprietor?:No
Enumeration Date:2018-04-30
Last Update Date:2018-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1548-60237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI237700000XMedicaid