Healthcare Provider Details

I. General information

NPI: 1528043247
Provider Name (Legal Business Name): MARY JANE HOBAN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 12/15/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PSC 827 BOX 130
FPO AE AE
09617
IT

IV. Provider business mailing address

PSC 827 BOX 130
FPO AE AE
09617
IT

V. Phone/Fax

Practice location:
  • Phone: 011390818116303
  • Fax:
Mailing address:
  • Phone: 011390818116303
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number422339
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number422339
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: