Healthcare Provider Details

I. General information

NPI: 1336986645
Provider Name (Legal Business Name): MARY MICHELLE HOBBS FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2024
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2423 N NATIONAL RD
COLUMBUS IN
47201-3733
US

IV. Provider business mailing address

2423 N NATIONAL RD
COLUMBUS IN
47201-3733
US

V. Phone/Fax

Practice location:
  • Phone: 866-389-2727
  • Fax:
Mailing address:
  • Phone: 812-372-7804
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71016611A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: