Basic Information
| Provider Information | |||||||||
| NPI: | 1225211105 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HOFFMAN | ||||||||
| FirstName: | RACHEL | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 69 | ||||||||
| Address2: | 590 MEDICAL PARK DR. | ||||||||
| City: | MARSHALL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287530069 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8286499566 | ||||||||
| FaxNumber: | 8286493786 | ||||||||
| Practice Location | |||||||||
| Address1: | 590 MEDICAL PARK DR. | ||||||||
| Address2: | |||||||||
| City: | MARSHALL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287536807 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8286493500 | ||||||||
| FaxNumber: | 8286491032 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/13/2007 | ||||||||
| LastUpdateDate: | 02/04/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | 101157 | NC | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363A00000X | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363AM0700X | 101157 | NC | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
ID Information
| ID | Type | State | Issuer | Description | 8102361 | 05 | NC | MEDICAID |