Healthcare Provider Details

I. General information

NPI: 1477993442
Provider Name (Legal Business Name): STEPHEN DUANE HOBSON CNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: STEVE DUANE HOBSON CNP

II. Dates (important events)

Enumeration Date: 07/05/2013
Last Update Date: 12/30/2020
Certification Date: 12/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

269 PORTLAND WAY S
GALION OH
44833-2312
US

IV. Provider business mailing address

269 PORTLAND WAY S
GALION OH
44833-2312
US

V. Phone/Fax

Practice location:
  • Phone: 419-468-4841
  • Fax:
Mailing address:
  • Phone: 419-571-9788
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCOA.14606-NP
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN.327449-COA1
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: