Provider Demographics
NPI:1790759223
Name:HOFFSTATTER, PATRICIA W (FNP)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:W
Last Name:HOFFSTATTER
Suffix:
Gender:F
Credentials:FNP
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 685
Mailing Address - Street 2:309 KENAI ST
Mailing Address - City:WHITTIER
Mailing Address - State:AK
Mailing Address - Zip Code:99693-0685
Mailing Address - Country:US
Mailing Address - Phone:907-299-3336
Mailing Address - Fax:907-472-2339
Practice Address - Street 1:301 KENAI ST
Practice Address - Street 2:POB 727
Practice Address - City:WHITTIER
Practice Address - State:AK
Practice Address - Zip Code:99693-0727
Practice Address - Country:US
Practice Address - Phone:907-472-2303
Practice Address - Fax:907-472-2339
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK20817163W00000X
NY303807-1163W00000X
AK728363LF0000X
NYF333398-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKNPO 728Medicaid