Healthcare Provider Details

I. General information

NPI: 1164833901
Provider Name (Legal Business Name): JAMIKA HOBBS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2014
Last Update Date: 05/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4801 E LINWOOD BLVD
KANSAS CITY MO
64128-2226
US

IV. Provider business mailing address

4801 E LINWOOD BLVD
KANSAS CITY MO
64128-2226
US

V. Phone/Fax

Practice location:
  • Phone: 816-719-8814
  • Fax:
Mailing address:
  • Phone: 816-719-8814
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number8600
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: