Healthcare Provider Details

I. General information

NPI: 1033603345
Provider Name (Legal Business Name): SYDNIE M HOBBS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2018
Last Update Date: 10/16/2024
Certification Date: 10/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1760 N 200 E STE 101
NORTH LOGAN UT
84341-1202
US

IV. Provider business mailing address

1760 N 200 E STE 101
NORTH LOGAN UT
84341-1202
US

V. Phone/Fax

Practice location:
  • Phone: 435-787-0560
  • Fax:
Mailing address:
  • Phone: 435-787-0560
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number58989
License Number StateID
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number8196449-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: