Provider Demographics
NPI:1548833882
Name:HOFFMAN, HAILEY (PA-C)
Entity type:Individual
Prefix:
First Name:HAILEY
Middle Name:
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:HAILEY
Other - Middle Name:
Other - Last Name:KHOURI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1200 MOUNTAIN ST STE 230
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89703-3867
Mailing Address - Country:US
Mailing Address - Phone:775-283-5029
Mailing Address - Fax:
Practice Address - Street 1:1946 OLD HOT SPRINGS RD
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89706-0674
Practice Address - Country:US
Practice Address - Phone:775-882-1324
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-23
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPA2829363AM0700X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine