Healthcare Provider Details

I. General information

NPI: 1093709321
Provider Name (Legal Business Name): MICHAEL TRENT HOBBS CNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2005
Last Update Date: 01/19/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5369 S CALLE SANTA CRUZ SUITE 145
TUCSON AZ
85706-3963
US

IV. Provider business mailing address

8927 S MYSTIC MEADOW RD
TUCSON AZ
85756-6172
US

V. Phone/Fax

Practice location:
  • Phone: 520-573-7500
  • Fax: 520-573-7557
Mailing address:
  • Phone: 520-308-0934
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR43004
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP3865
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: