Healthcare Provider Details

I. General information

NPI: 1568988574
Provider Name (Legal Business Name): LAURA HOBSON PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAURA KREMER PA-C

II. Dates (important events)

Enumeration Date: 08/22/2017
Last Update Date: 11/11/2022
Certification Date: 11/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

334 THOMAS MORE PKWY
CRESTVIEW HILLS KY
41017
US

IV. Provider business mailing address

PO BOX 635283
CINCINNATI OH
45263-5283
US

V. Phone/Fax

Practice location:
  • Phone: 859-301-5901
  • Fax: 859-301-5940
Mailing address:
  • Phone: 859-301-5901
  • Fax: 859-301-5940

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA2288
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: