Healthcare Provider Details

I. General information

NPI: 1184546939
Provider Name (Legal Business Name): JASMINE ANNA HOBBS CNP, ACNPC-AG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1423 E ROOSEVELT AVE
GRANTS NM
87020-2245
US

IV. Provider business mailing address

617 E STEPHENS AVE
GRANTS NM
87020-2423
US

V. Phone/Fax

Practice location:
  • Phone: 505-287-6500
  • Fax:
Mailing address:
  • Phone: 505-290-3099
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number57954
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: