Provider Demographics
NPI:1861475089
Name:HOFFMAN, MAGDALENE CHANDRAVATHANA (CFNP)
Entity Type:Individual
Prefix:
First Name:MAGDALENE
Middle Name:CHANDRAVATHANA
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 CHARLES ST
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-3312
Mailing Address - Country:US
Mailing Address - Phone:540-347-8140
Mailing Address - Fax:
Practice Address - Street 1:2500 CHARLES ST
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-3312
Practice Address - Country:US
Practice Address - Phone:540-347-8140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024166724363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily