Basic Information
| Provider Information | |||||||||
| NPI: | 1326016619 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HOFFSTETTER | ||||||||
| FirstName: | SUSAN | ||||||||
| MiddleName: | E | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | PHD NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6420 CLAYTON RD | ||||||||
| Address2: | STE. 290 | ||||||||
| City: | SAINT LOUIS | ||||||||
| State: | MO | ||||||||
| PostalCode: | 631171811 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3147811031 | ||||||||
| FaxNumber: | 3147812840 | ||||||||
| Practice Location | |||||||||
| Address1: | 1031 BELLEVUE AVE STE 200 | ||||||||
| Address2: | |||||||||
| City: | SAINT LOUIS | ||||||||
| State: | MO | ||||||||
| PostalCode: | 631171856 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3149777455 | ||||||||
| FaxNumber: | 3149777477 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/10/2006 | ||||||||
| LastUpdateDate: | 01/14/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/14/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LW0102X | NCCIDHOF104301125 | MO | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Women's Health |
No ID Information.