Healthcare Provider Details

I. General information

NPI: 1982854782
Provider Name (Legal Business Name): MARGARET JEAN HOBERG NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2008
Last Update Date: 03/18/2021
Certification Date: 03/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 EAST 3RD STREET SMDC MEDICAL CENTER-DULUTH CLINIC
DULUTH MN
55805
US

IV. Provider business mailing address

1702 UNIVERSITY DR S-SSC MEDICAL STAFF SERVICE
FARGO ND
58103-4940
US

V. Phone/Fax

Practice location:
  • Phone: 218-786-1216
  • Fax:
Mailing address:
  • Phone: 218-606-9396
  • Fax: 701-364-8476

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberR152213-4
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number3799-33
License Number StateWI
# 3
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberR152213-4
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: