Provider Demographics
NPI:1598905150
Name:HOFLER, LYNNETTE IRENE (RN)
Entity Type:Individual
Prefix:MS
First Name:LYNNETTE
Middle Name:IRENE
Last Name:HOFLER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50700 NW CEDAR CANYON RD
Mailing Address - Street 2:
Mailing Address - City:BANKS
Mailing Address - State:OR
Mailing Address - Zip Code:97106-8816
Mailing Address - Country:US
Mailing Address - Phone:503-481-5004
Mailing Address - Fax:
Practice Address - Street 1:50700 NW CEDAR CANYON RD
Practice Address - Street 2:
Practice Address - City:BANKS
Practice Address - State:OR
Practice Address - Zip Code:97106-8816
Practice Address - Country:US
Practice Address - Phone:503-481-5004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-23
Last Update Date:2009-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR079037259RN163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse