Provider Demographics
NPI:1356519938
Name:HOFFERT, DARLEEN C (DNP RN AGNP-C QMHP)
Entity type:Individual
Prefix:MS
First Name:DARLEEN
Middle Name:C
Last Name:HOFFERT
Suffix:
Gender:F
Credentials:DNP RN AGNP-C QMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 4TH ST NW
Mailing Address - Street 2:PO BOX 1088
Mailing Address - City:PULASKI
Mailing Address - State:VA
Mailing Address - Zip Code:24301
Mailing Address - Country:US
Mailing Address - Phone:540-980-0922
Mailing Address - Fax:540-980-2931
Practice Address - Street 1:25 4TH ST NW
Practice Address - Street 2:
Practice Address - City:PULASKI
Practice Address - State:VA
Practice Address - Zip Code:24301-4613
Practice Address - Country:US
Practice Address - Phone:540-980-0922
Practice Address - Fax:540-980-2931
Is Sole Proprietor?:No
Enumeration Date:2008-02-15
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704236066163W00000X, 363LG0600X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0001287899OtherSTATE OF VIRGINIA RN LICENSE
MI4704236066OtherSTATE OF MICHIGAN LICENSE
VA00241788175OtherSTATE OF VIRGINIA NP LICENSE