Provider Demographics
NPI:1174525158
Name:HOFF-THOMAS, SUSAN (ARNP)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:HOFF-THOMAS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1720 NICHOLASVILLE RD
Mailing Address - Street 2:SUITE 602
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-1475
Mailing Address - Country:US
Mailing Address - Phone:859-277-4005
Mailing Address - Fax:859-278-2507
Practice Address - Street 1:1720 NICHOLASVILLE RD
Practice Address - Street 2:SUITE 602
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-1475
Practice Address - Country:US
Practice Address - Phone:859-277-4005
Practice Address - Fax:859-278-2507
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3787P363LC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LC0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYQ35505Medicare UPIN
KY0234510Medicare ID - Type Unspecified