Provider Demographics
NPI:1912621160
Name:HOFBAUER, EMILY (RN)
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:
Last Name:HOFBAUER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:EMILY
Other - Middle Name:
Other - Last Name:ELLISON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:PO BOX 881055
Mailing Address - Street 2:
Mailing Address - City:STEILACOOM
Mailing Address - State:WA
Mailing Address - Zip Code:98388-0616
Mailing Address - Country:US
Mailing Address - Phone:253-341-2418
Mailing Address - Fax:
Practice Address - Street 1:54 SENTINEL DR
Practice Address - Street 2:
Practice Address - City:STEILACOOM
Practice Address - State:WA
Practice Address - Zip Code:98388-1663
Practice Address - Country:US
Practice Address - Phone:253-439-8880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-30
Last Update Date:2022-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60980178163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse