Basic Information
| Provider Information | |||||||||
| NPI: | 1831657642 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HOFFMAN | ||||||||
| FirstName: | PARKER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2000 Q ST STE 500 | ||||||||
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| City: | LINCOLN | ||||||||
| State: | NE | ||||||||
| PostalCode: | 685033610 | ||||||||
| CountryCode: | US | ||||||||
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| FaxNumber: | 4024210946 | ||||||||
| Practice Location | |||||||||
| Address1: | 7440 S 91ST ST | ||||||||
| Address2: | |||||||||
| City: | LINCOLN | ||||||||
| State: | NE | ||||||||
| PostalCode: | 685269797 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4024896555 | ||||||||
| FaxNumber: | 4023283770 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/11/2019 | ||||||||
| LastUpdateDate: | 10/22/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AS0400X | 2389 | NE | Y | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Surgical |
No ID Information.