Healthcare Provider Details

I. General information

NPI: 1861148454
Provider Name (Legal Business Name): BOBBI SUE HULLUM APRN CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BOBBI HODGE

II. Dates (important events)

Enumeration Date: 02/23/2022
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 SOUTH JEFFERSON STREET
NEW CASTLE PA
16101
US

IV. Provider business mailing address

200 SOUTH JEFFERSON STREET
NEW CASTLE PA
16101
US

V. Phone/Fax

Practice location:
  • Phone: 724-658-6681
  • Fax:
Mailing address:
  • Phone: 724-658-6681
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAPRN.CNP.0030834
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberSP034154
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: