Provider Demographics
NPI:1629813860
Name:HOFFER, NINA BRIELLE (DNP, CNM)
Entity type:Individual
Prefix:
First Name:NINA
Middle Name:BRIELLE
Last Name:HOFFER
Suffix:
Gender:F
Credentials:DNP, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9018 W 24TH ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90034-1939
Mailing Address - Country:US
Mailing Address - Phone:310-487-2304
Mailing Address - Fax:
Practice Address - Street 1:20696 BOND RD NE STE 110
Practice Address - Street 2:
Practice Address - City:POULSBO
Practice Address - State:WA
Practice Address - Zip Code:98370-9025
Practice Address - Country:US
Practice Address - Phone:360-779-0004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-28
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN61322357163W00000X
WA367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163W00000XNursing Service ProvidersRegistered Nurse