Basic Information
| Provider Information | |||||||||
| NPI: | 1386005056 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | HOFER | ||||||||
| FirstName: | LAURA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1000 E 23RD ST | ||||||||
| Address2: | 230 | ||||||||
| City: | SIOUX FALLS | ||||||||
| State: | SD | ||||||||
| PostalCode: | 571052108 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6052702363 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1000 E 23RD ST | ||||||||
| Address2: | 230 | ||||||||
| City: | SIOUX FALLS | ||||||||
| State: | SD | ||||||||
| PostalCode: | 571052108 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6053226900 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/09/2016 | ||||||||
| LastUpdateDate: | 03/09/2016 | ||||||||
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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 | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.