Healthcare Provider Details

I. General information

NPI: 1336107473
Provider Name (Legal Business Name): GREGORY NELSON HOBBS NURSE PRACTITIONER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2006
Last Update Date: 03/09/2020
Certification Date: 03/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2126 N HIGHWAY 81
ANDERSON SC
29621-1532
US

IV. Provider business mailing address

2126 N HIGHWAY 81
ANDERSON SC
29621-1532
US

V. Phone/Fax

Practice location:
  • Phone: 864-226-2660
  • Fax:
Mailing address:
  • Phone: 864-226-2660
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF1282
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: