Provider Demographics
NPI:1699162198
Name:HOBONGWANA, SARAH LINDIWE (CRNP)
Entity type:Individual
Prefix:MS
First Name:SARAH
Middle Name:LINDIWE
Last Name:HOBONGWANA
Suffix:
Gender:
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:531 HARKLE RD STE B
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-4753
Mailing Address - Country:US
Mailing Address - Phone:505-207-8078
Mailing Address - Fax:505-207-8078
Practice Address - Street 1:531 HARKLE RD STE B
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-4753
Practice Address - Country:US
Practice Address - Phone:505-207-8078
Practice Address - Fax:505-207-8078
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-22
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM57060207RI0200X
MDR196063363LG0600X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology