Provider Demographics
NPI:1750331377
Name:HOFFMANN, MARTHA KINGSTON (PA-C)
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:KINGSTON
Last Name:HOFFMANN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2570
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28793-2570
Mailing Address - Country:US
Mailing Address - Phone:828-693-4431
Mailing Address - Fax:828-693-4434
Practice Address - Street 1:510 BALSAM RD
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28792-5703
Practice Address - Country:US
Practice Address - Phone:828-693-4431
Practice Address - Fax:828-693-4434
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2013-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC102228363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCP47364Medicare UPIN
NC2754088Medicare PIN
NC2754088CMedicare PIN