Provider Demographics
NPI:1619313772
Name:HOFE, CAROLYN (RD PHD LD)
Entity Type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:
Last Name:HOFE
Suffix:
Gender:F
Credentials:RD PHD LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40502-1602
Mailing Address - Country:US
Mailing Address - Phone:859-321-8312
Mailing Address - Fax:859-268-4147
Practice Address - Street 1:710 E MAIN ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40502-1602
Practice Address - Country:US
Practice Address - Phone:859-321-8312
Practice Address - Fax:859-268-4147
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-16
Last Update Date:2015-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133N00000X
KYKY-1802133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133N00000XDietary & Nutritional Service ProvidersNutritionist