National Provider Identifier Database

TIANA M IMHOFF, PA-C – NPI #1487094686
Surgical


Contact Information

TIANA M IMHOFF, PA-C
1515 PARK AVE
COLUMBUS, WI53925
Phone: 920-623-2200
Fax:
Website:
Specialty Taxonomy Code
* Surgical 363AS0400X

* Indicates primary specialty

NPI Profile & details for TIANA M IMHOFF

NPI Number 1487094686
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 07/02/2013
Last updated 11/27/2023 - About 3 years ago
Sole proprietor1 No
Identifiers
  • WI License #: 3158-23
  • WI Medicaid: 1487094686
  • WI Other: 1487094686 BCBSWI
  • WI Other: WEISSTIA MERCYCARE INSURANCE
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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