Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LG0600X | Nurse Practitioner - Gerontology | 28179901A | IN |
NPI | 1073024261 |
---|---|
Provider Name | Christina Hobbs |
First Address | Indianapolis, IN 46203-4519 |
Second Address | Indianapolis, IN 46202-2803 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2017 |
Last Update Date | 16/10/2017 |