Healthcare Provider Details

I. General information

NPI: 1891701835
Provider Name (Legal Business Name): ROBERT A HOBBS JR. APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 02/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3012 EASTPOINT PKWY
LOUISVILLE KY
40223-4185
US

IV. Provider business mailing address

3012 EASTPOINT PKWY
LOUISVILLE KY
40223-4185
US

V. Phone/Fax

Practice location:
  • Phone: 502-365-4545
  • Fax: 502-365-4546
Mailing address:
  • Phone: 502-365-4545
  • Fax: 502-365-4546

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number3004876
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number3004876
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1096562
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: