Healthcare Provider Details

I. General information

NPI: 1104153055
Provider Name (Legal Business Name): SHERDINA Q HOBSON R.N., CRNP, ANP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SHERDINA Q CORRY MSN, ANP-BC, CRNP

II. Dates (important events)

Enumeration Date: 11/13/2009
Last Update Date: 11/27/2023
Certification Date: 11/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5835 CAMPBELLTON RD SW STE 103
ATLANTA GA
30331-8014
US

IV. Provider business mailing address

5835 CAMPBELLTON RD SW STE 103
ATLANTA GA
30331-8014
US

V. Phone/Fax

Practice location:
  • Phone: 404-549-2505
  • Fax:
Mailing address:
  • Phone: 404-549-2505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberRN303589
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberSP010546
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: