Healthcare Provider Details

I. General information

NPI: 1467565036
Provider Name (Legal Business Name): PEGGY SUE HOBUS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2006
Last Update Date: 03/04/2022
Certification Date: 03/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2510 BELLEVUE MEDICAL CENTER DR STE 145A
BELLEVUE NE
68123-1556
US

IV. Provider business mailing address

302 N CHESTNUT ST PO BOX 342
AVOCA IA
51521-5142
US

V. Phone/Fax

Practice location:
  • Phone: 402-779-7207
  • Fax: 402-779-7210
Mailing address:
  • Phone: 402-680-9564
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberA081496
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: