Healthcare Provider Details
I. General information
NPI: 1356627418
Provider Name (Legal Business Name): ELIZABETH HOBBS R.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 11/02/2011
Last Update Date: 11/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2120 DRESSLER DR
COVINGTON VA
24426-6109
US
IV. Provider business mailing address
2120 DRESSLER DR
COVINGTON VA
24426-6109
US
V. Phone/Fax
- Phone: 540-962-8902
- Fax: 540-962-8902
- Phone: 540-962-8902
- Fax: 540-962-8902
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 133V00000X |
| Taxonomy | Registered Dietitian |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 133VN1005X |
| Taxonomy | Renal Nutrition Registered Dietitian |
| License Number | 410 |
| License Number State | WV |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 133VN1006X |
| Taxonomy | Metabolic Nutrition Registered Dietitian |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: