Provider Demographics
NPI:1922843614
Name:HOFFMAN, JACLYN (RN)
Entity type:Individual
Prefix:MRS
First Name:JACLYN
Middle Name:
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3409 WHITNEY AVE APT 4
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06518-1958
Mailing Address - Country:US
Mailing Address - Phone:413-454-2418
Mailing Address - Fax:
Practice Address - Street 1:3409 WHITNEY AVE APT 4
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06518-1958
Practice Address - Country:US
Practice Address - Phone:413-454-2418
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-26
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT192790163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics