Healthcare Provider Details

I. General information

NPI: 1114741733
Provider Name (Legal Business Name): MRS. ALEXANDRA RAY HOBBS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/11/2024
Last Update Date: 11/11/2024
Certification Date: 11/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 MEDICAL PAVILION DR
RAEFORD NC
28376-9111
US

IV. Provider business mailing address

245 QUAIL RUN
PINEHURST NC
28374-9099
US

V. Phone/Fax

Practice location:
  • Phone: 910-904-8000
  • Fax:
Mailing address:
  • Phone: 251-978-8269
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5021136
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: