Provider Demographics
NPI:1477286813
Name:HOFFMANN, LIZ BOUDREAUX (RN, IBCLC)
Entity type:Individual
Prefix:
First Name:LIZ
Middle Name:BOUDREAUX
Last Name:HOFFMANN
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 LAGARDE ST
Mailing Address - Street 2:
Mailing Address - City:THIBODAUX
Mailing Address - State:LA
Mailing Address - Zip Code:70301-3429
Mailing Address - Country:US
Mailing Address - Phone:985-413-4729
Mailing Address - Fax:
Practice Address - Street 1:625 LAGARDE ST
Practice Address - Street 2:
Practice Address - City:THIBODAUX
Practice Address - State:LA
Practice Address - Zip Code:70301-3429
Practice Address - Country:US
Practice Address - Phone:985-413-4729
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-04
Last Update Date:2022-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN058516163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant