Provider Demographics
NPI:1942975669
Name:HOFFMAN, MOLLY LETOURE (APRN, ACAG-BC)
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:LETOURE
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:APRN, ACAG-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 MIAMI VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45459-4774
Mailing Address - Country:US
Mailing Address - Phone:937-208-8394
Mailing Address - Fax:937-401-4560
Practice Address - Street 1:2400 MIAMI VALLEY DR
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45459-4774
Practice Address - Country:US
Practice Address - Phone:937-208-8394
Practice Address - Fax:937-401-4560
Is Sole Proprietor?:No
Enumeration Date:2021-08-13
Last Update Date:2021-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.386208163W00000X
OHAPRN.CNP.0029529363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163W00000XNursing Service ProvidersRegistered Nurse