Healthcare Provider Details
I. General information
NPI: 1255680070
Provider Name (Legal Business Name): LAURA ELIZABETH HOBBS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/07/2012
Last Update Date: 09/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3620 HOWELL FERRY RD
DULUTH GA
30096-3178
US
IV. Provider business mailing address
3702 ASHFORD CREEK HL NE
ATLANTA GA
30319-5058
US
V. Phone/Fax
- Phone: 678-312-6800
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0200X |
| Taxonomy | Pediatric Nurse Practitioner |
| License Number | RN225115 |
| License Number State | GA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LP0200X |
| Taxonomy | Pediatric Nurse Practitioner |
| License Number | 71003996A |
| License Number State | IN |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LP0200X |
| Taxonomy | Pediatric Nurse Practitioner |
| License Number | 71003996B |
| License Number State | IN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: