Healthcare Provider Details

I. General information

NPI: 1740876051
Provider Name (Legal Business Name): KALEIGH MARIE HOBBS RN, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/21/2020
Last Update Date: 12/21/2020
Certification Date: 12/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1428 S MAIN ST STE 3
OTTAWA KS
66067-3547
US

IV. Provider business mailing address

1428 S MAIN ST STE 3
OTTAWA KS
66067-3547
US

V. Phone/Fax

Practice location:
  • Phone: 785-229-8232
  • Fax: 785-248-2899
Mailing address:
  • Phone: 785-229-8232
  • Fax: 785-248-2899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number122044
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License NumberL-301566
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: