Provider Demographics
NPI:1295805729
Name:HOFFHEINS, KELLY (RD, LDN)
Entity type:Individual
Prefix:MS
First Name:KELLY
Middle Name:
Last Name:HOFFHEINS
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:MS
Other - First Name:KELLY
Other - Middle Name:
Other - Last Name:KARNS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD, LDN
Mailing Address - Street 1:1531 HIDDEN VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:MONTOURSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17754-9318
Mailing Address - Country:US
Mailing Address - Phone:570-321-0723
Mailing Address - Fax:
Practice Address - Street 1:1100 GRAMPIAN BLVD
Practice Address - Street 2:DIVINE PROVIDENCE HOSPITAL, DIABETES CENTER
Practice Address - City:WILLIAMSPORT
Practice Address - State:PA
Practice Address - Zip Code:17701-1909
Practice Address - Country:US
Practice Address - Phone:570-326-8410
Practice Address - Fax:570-326-8414
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA930983133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered