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General NPI Number Information
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NPI Number | 1245350099
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Entity Type | Individual
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Provider Name | KATRINA HAZEL-RENEE HOBSON CNP
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Gender | Female
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Dates
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Enumeration Date | 03/29/2007
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Last Update Date | 07/23/2024
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Provider Practice Location Address
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Address Line | 6000 FREEDOM SQUARE DR
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City | INDEPENDENCE
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State | OH
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Zip | 44131-2577
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Country | US
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Telephone | 947-209-1473
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Fax |
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Provider Business Mailing Address
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Address Line | 313 REDWOOD DR
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City | TROY
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State | MI
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Zip | 48083-1065
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Country | US
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Telephone | 248-802-2848
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 0036283
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | LP-0010726
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License Number State | DE
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Taxonomy #3
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 13064
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License Number State | CT
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Taxonomy #4
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 267996
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License Number State | AZ
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Taxonomy #5
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | A0405092
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License Number State | MI
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