Provider Demographics
NPI:1871886937
Name:HOFFMAN, REBECCA CHRISTINE (CAA)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:CHRISTINE
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:CAA
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:CHRISTINE
Other - Last Name:HOYE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AA-C
Mailing Address - Street 1:PO BOX 5
Mailing Address - Street 2:
Mailing Address - City:HAZELWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63042-0005
Mailing Address - Country:US
Mailing Address - Phone:314-895-3828
Mailing Address - Fax:314-895-3827
Practice Address - Street 1:10 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-1659
Practice Address - Country:US
Practice Address - Phone:314-895-3828
Practice Address - Fax:314-895-3827
Is Sole Proprietor?:No
Enumeration Date:2011-05-24
Last Update Date:2018-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011014317367H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant