Healthcare Provider Details

I. General information

NPI: 1396337986
Provider Name (Legal Business Name): ABBEY HOBART APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2021
Last Update Date: 01/07/2022
Certification Date: 01/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3530 WESTGATE STE D-432
FAIRVIEW PARK OH
44126-1300
US

IV. Provider business mailing address

124 WOODHILL DR
AMHERST OH
44001-1614
US

V. Phone/Fax

Practice location:
  • Phone: 440-356-4265
  • Fax:
Mailing address:
  • Phone: 440-731-0289
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number0028289
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: