Healthcare Provider Details

I. General information

NPI: 1295344109
Provider Name (Legal Business Name): KELSEY LYNN HOBBS DNP, APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KELSEY LYNN HOBBS

II. Dates (important events)

Enumeration Date: 07/27/2020
Last Update Date: 02/08/2021
Certification Date: 02/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2550 LUSK DR
NEOSHO MO
64850-8855
US

IV. Provider business mailing address

2550 LUSK DR
NEOSHO MO
64850-8855
US

V. Phone/Fax

Practice location:
  • Phone: 174-512-0604
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2020020505
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: