Provider Demographics
NPI:1750611984
Name:HOFF, KERA LEIGH (CSA)
Entity type:Individual
Prefix:MS
First Name:KERA
Middle Name:LEIGH
Last Name:HOFF
Suffix:
Gender:F
Credentials:CSA
Other - Prefix:MRS
Other - First Name:KERA
Other - Middle Name:LEIGH
Other - Last Name:GIBBS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CSA
Mailing Address - Street 1:211 10TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55904-4614
Mailing Address - Country:US
Mailing Address - Phone:507-993-1289
Mailing Address - Fax:
Practice Address - Street 1:201 W CENTER ST
Practice Address - Street 2:EI-01 SURGICAL ASSISTANTS
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55902-3003
Practice Address - Country:US
Practice Address - Phone:507-266-2827
Practice Address - Fax:507-266-1978
Is Sole Proprietor?:No
Enumeration Date:2010-01-11
Last Update Date:2010-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical