Provider Demographics
NPI:1194092700
Name:HOBBS, VICKIE LYNN
Entity type:Individual
Prefix:MRS
First Name:VICKIE
Middle Name:LYNN
Last Name:HOBBS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:VICKIE
Other - Middle Name:LYNN
Other - Last Name:EKERN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:427 DAHLIA ST
Mailing Address - Street 2:
Mailing Address - City:FORT MORGAN
Mailing Address - State:CO
Mailing Address - Zip Code:80701-3923
Mailing Address - Country:US
Mailing Address - Phone:970-370-4781
Mailing Address - Fax:
Practice Address - Street 1:427 DAHLIA ST
Practice Address - Street 2:
Practice Address - City:FORT MORGAN
Practice Address - State:CO
Practice Address - Zip Code:80701-3923
Practice Address - Country:US
Practice Address - Phone:970-370-4781
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-28
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker