Provider Demographics
NPI:1871674630
Name:HOFFMAN, KIMBERLY ANN (AUD)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:ANN
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 HARMONY CROSSING
Mailing Address - Street 2:SUITE 8
Mailing Address - City:EATONTON
Mailing Address - State:GA
Mailing Address - Zip Code:31024-5285
Mailing Address - Country:US
Mailing Address - Phone:706-453-2119
Mailing Address - Fax:706-467-9068
Practice Address - Street 1:117 HARMONY XING STE 8
Practice Address - Street 2:
Practice Address - City:EATONTON
Practice Address - State:GA
Practice Address - Zip Code:31024-9549
Practice Address - Country:US
Practice Address - Phone:706-445-3211
Practice Address - Fax:706-467-9068
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAUD003689231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA511I640088OtherPTAN
GAQ30233Medicare UPIN