Individual
THERESA M HOFFOSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
WHCNP
Contact information
Practice address
2603 WHITE BEAR AVE N, MAPLEWOOD, MN 55109-5110
(651) 600-3035
(651) 348-8783
Mailing address
5124 39TH AVE S, MINNEAPOLIS, MN 55417-1652
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
R161997-9
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
966496300
—
MN
Enumeration date
01/24/2006
Last updated
02/15/2018
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