Provider Demographics
NPI:1023276151
Name:HOFSTETTER, RENE L (NP)
Entity type:Individual
Prefix:MRS
First Name:RENE
Middle Name:L
Last Name:HOFSTETTER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 S KINGSHIGHWAY BLVD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-1026
Mailing Address - Country:US
Mailing Address - Phone:314-419-2521
Mailing Address - Fax:
Practice Address - Street 1:#1 BARNES JEWISH HOSPITAL PLAZA
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1026
Practice Address - Country:US
Practice Address - Phone:314-419-2521
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-27
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO106615363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health