Provider Demographics
NPI:1740905868
Name:VON HOFFMANN, HILARY CHRISTINE (AG-ACNP, BC)
Entity type:Individual
Prefix:MRS
First Name:HILARY
Middle Name:CHRISTINE
Last Name:VON HOFFMANN
Suffix:
Gender:F
Credentials:AG-ACNP, BC
Other - Prefix:MS
Other - First Name:HILARY
Other - Middle Name:CHRISTINE
Other - Last Name:MITTRUCKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AG-ACNP, BC
Mailing Address - Street 1:16864 RED DRAGON PL
Mailing Address - Street 2:
Mailing Address - City:WILDWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63011-5506
Mailing Address - Country:US
Mailing Address - Phone:314-420-7583
Mailing Address - Fax:
Practice Address - Street 1:615 S NEW BALLAS RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-8221
Practice Address - Country:US
Practice Address - Phone:314-251-6339
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-11
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOPENDING363LA2100X
MO2015018878163W00000X
MO2022041013363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163W00000XNursing Service ProvidersRegistered Nurse