Provider Demographics
NPI:1689378044
Name:HOFMEISTER, EMILY ROSE
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:ROSE
Last Name:HOFMEISTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3130 N SNOW GOOSE DR
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99654-2501
Mailing Address - Country:US
Mailing Address - Phone:760-684-0322
Mailing Address - Fax:
Practice Address - Street 1:3130 N SNOW GOOSE DR
Practice Address - Street 2:
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654-2501
Practice Address - Country:US
Practice Address - Phone:760-684-0322
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-29
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist