Provider Demographics
NPI:1356717011
Name:HOFFMANN, BREANNA K (OD)
Entity type:Individual
Prefix:
First Name:BREANNA
Middle Name:K
Last Name:HOFFMANN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:353 N 8TH ST
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:WI
Mailing Address - Zip Code:54451-1515
Mailing Address - Country:US
Mailing Address - Phone:715-748-2020
Mailing Address - Fax:715-748-4565
Practice Address - Street 1:353 N 8TH ST
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:WI
Practice Address - Zip Code:54451-1515
Practice Address - Country:US
Practice Address - Phone:715-748-2020
Practice Address - Fax:715-748-4565
Is Sole Proprietor?:No
Enumeration Date:2015-08-18
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2068152W00000X
WI374835152W00000X
WI3748-35152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist