Provider Demographics
NPI:1437224862
Name:HOFFA, KIMBERLY ANN (DC)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:ANN
Last Name:HOFFA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5925 N 28TH ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68504-9820
Mailing Address - Country:US
Mailing Address - Phone:402-441-4160
Mailing Address - Fax:402-441-4164
Practice Address - Street 1:5925 N 28TH ST
Practice Address - Street 2:SUITE 100
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68504-9820
Practice Address - Country:US
Practice Address - Phone:402-441-4160
Practice Address - Fax:402-441-4164
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2014-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1376111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE1689918922OtherNATIONAL PROVIDER ID
NE10025355200Medicaid
NE45-3649164OtherFEDERAL TAX ID NUMBER
NENA2258001Medicare UPIN