Provider Demographics
NPI:1760030084
Name:HOFFMAN, DAVA CHRISTINE (PA-C)
Entity Type:Individual
Prefix:
First Name:DAVA
Middle Name:CHRISTINE
Last Name:HOFFMAN
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 1:303 N GEORGIA ST
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MO
Mailing Address - Zip Code:63755-1412
Mailing Address - Country:US
Mailing Address - Phone:636-377-9047
Mailing Address - Fax:
Practice Address - Street 1:1723 BROADWAY ST STE 315
Practice Address - Street 2:
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63701-4556
Practice Address - Country:US
Practice Address - Phone:573-519-4960
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-29
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant