Provider Demographics
NPI:1144315763
Name:HOFFMANN, TERESA A (FNP-BC)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:A
Last Name:HOFFMANN
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9200 INDIAN CREEK PKWY
Mailing Address - Street 2:BLDG. 9, STE. 300
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-2036
Mailing Address - Country:US
Mailing Address - Phone:913-574-2800
Mailing Address - Fax:913-574-2336
Practice Address - Street 1:4881 NE GOODVIEW CIR
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64064-1996
Practice Address - Country:US
Practice Address - Phone:913-574-2350
Practice Address - Fax:913-574-2413
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS45410363LF0000X
MO145651363LF0000X, 163W00000X
KS14-86097-102163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1144315763Medicaid
KS200004570DMedicaid
Q06052Medicare UPIN
MOP01005462Medicare PIN
MO1144315763Medicaid