Basic Information
| Provider Information | |||||||||
| NPI: | 1831299825 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HOFF | ||||||||
| FirstName: | MARY | ||||||||
| MiddleName: | ELIZABETH | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | CPNP, NP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2060 CARLISLE RD | ||||||||
| Address2: | |||||||||
| City: | ASPERS | ||||||||
| State: | PA | ||||||||
| PostalCode: | 173049707 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7178404092 | ||||||||
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| Practice Location | |||||||||
| Address1: | 40 W WELLSBORO ST | ||||||||
| Address2: | |||||||||
| City: | MANSFIELD | ||||||||
| State: | PA | ||||||||
| PostalCode: | 169331411 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5706622002 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/22/2006 | ||||||||
| LastUpdateDate: | 11/04/2016 | ||||||||
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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 | 363LF0000X | SP010422 | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | 0009089200001 | 05 | PA | MEDICAID | 809331 | 01 | HEALTH CARE ADVANTAGE | OTHER |