Healthcare Provider Details

I. General information

NPI: 1477188134
Provider Name (Legal Business Name): SANDRA DENISE HOBSON NURSE PRACTITIONER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/03/2020
Last Update Date: 10/23/2025
Certification Date: 10/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3807 ATRISCO DR NW STE A
ALBUQUERQUE NM
87120-4907
US

IV. Provider business mailing address

3807 ATRISCO DR NW STE A
ALBUQUERQUE NM
87120-4907
US

V. Phone/Fax

Practice location:
  • Phone: 505-839-1111
  • Fax: 505-485-0402
Mailing address:
  • Phone: 505-839-1111
  • Fax: 505-485-0402

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number59019
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number5019
License Number StateNM
# 3
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number5019
License Number StateNM
# 4
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number5019
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: