Provider Demographics
NPI:1952610446
Name:HOEFLER, NICKELE JEAN (PA)
Entity Type:Individual
Prefix:MRS
First Name:NICKELE
Middle Name:JEAN
Last Name:HOEFLER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:MS
Other - First Name:NICKELE
Other - Middle Name:JEAN
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:1600 CHARLES PL
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-2750
Mailing Address - Country:US
Mailing Address - Phone:785-537-4200
Mailing Address - Fax:785-537-4354
Practice Address - Street 1:1600 CHARLES PL
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-2750
Practice Address - Country:US
Practice Address - Phone:785-537-4200
Practice Address - Fax:785-537-4354
Is Sole Proprietor?:No
Enumeration Date:2010-09-30
Last Update Date:2014-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1501744363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant