1679719785 NPI number — MS. JILLAINE RUTH HOBSON RN PNP

Table of content: MS. JILLAINE RUTH HOBSON RN PNP (NPI 1679719785)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679719785 NPI number — MS. JILLAINE RUTH HOBSON RN PNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HOBSON
Provider First Name:
JILLAINE
Provider Middle Name:
RUTH
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
RN PNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1679719785
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/18/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4745 ARAPAHOE AVE
Provider Second Line Business Mailing Address:
SUITE 310
Provider Business Mailing Address City Name:
BOULDER
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80303-1080
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-442-2913
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4745 ARAPAHOE AVE
Provider Second Line Business Practice Location Address:
SUITE 310
Provider Business Practice Location Address City Name:
BOULDER
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80303-1080
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-442-2913
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/18/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LP0200X , with the licence number:  RXN, NP 61583 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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