Healthcare Provider Details

I. General information

NPI: 1346098902
Provider Name (Legal Business Name): JESSICA ANNE HOBSON RN/CHHP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JESSICA HOBSON RN/CHHP

II. Dates (important events)

Enumeration Date: 05/08/2024
Last Update Date: 05/08/2024
Certification Date: 05/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 N WILLOW
STRATFORD OK
74872-4420
US

IV. Provider business mailing address

330 N WILLOW
STRATFORD OK
74872-4420
US

V. Phone/Fax

Practice location:
  • Phone: 405-207-6022
  • Fax:
Mailing address:
  • Phone: 405-207-6602
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number099440
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: