Provider Demographics
NPI:1124493911
Name:HOBERT, AMY
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:HOBERT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 SE 11TH ST UNIT 502
Mailing Address - Street 2:
Mailing Address - City:GRIMES
Mailing Address - State:IA
Mailing Address - Zip Code:50111-2290
Mailing Address - Country:US
Mailing Address - Phone:319-239-3879
Mailing Address - Fax:
Practice Address - Street 1:301 SE 11TH ST UNIT 502
Practice Address - Street 2:
Practice Address - City:GRIMES
Practice Address - State:IA
Practice Address - Zip Code:50111-2290
Practice Address - Country:US
Practice Address - Phone:319-239-3879
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-06
Last Update Date:2015-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA118404163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care