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Individual

MRS. JACQUELINE RAE HOFMEISTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AGPCNP-C

Contact information

Practice address
20000 HARVARD AVE STE 1002, WARRENSVILLE HEIGHTS, OH 44122-6805
(216) 991-2600
Mailing address
1365 ATTERBURY DR, MACEDONIA, OH 44056-2431
(330) 468-5196

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
338800
OH
363LA2200X
Adult Health Nurse Practitioner
Primary
15574
OH
363LA2200X
Adult Health Nurse Practitioner
338800
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0143552
OH
Enumeration date
12/31/2013
Last updated
02/18/2022
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