Healthcare Provider Details

I. General information

NPI: 1720434236
Provider Name (Legal Business Name): KRISTINA HOBBS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/13/2016
Last Update Date: 05/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 VILLAGE DR # GL30
SAINT JOSEPH MO
64506-4979
US

IV. Provider business mailing address

109 N SMITH ST
SMITHVILLE MO
64089-8894
US

V. Phone/Fax

Practice location:
  • Phone: 816-545-9203
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: