Healthcare Provider Details

I. General information

NPI: 1174162671
Provider Name (Legal Business Name): MATTHEW HOBBS PMHNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/31/2019
Last Update Date: 04/17/2023
Certification Date: 04/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3608 UNIVERSITY DR STE 101
DURHAM NC
27707-6260
US

IV. Provider business mailing address

3608 UNIVERSITY DR STE 101
DURHAM NC
27707-6260
US

V. Phone/Fax

Practice location:
  • Phone: 919-433-0170
  • Fax: 919-226-0026
Mailing address:
  • Phone: 919-433-0170
  • Fax: 919-226-0026

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number5012689
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: