Johanna Mae Hobbs, CSA

Individual provider Active NPI Surgical Assistant · Muldraugh, KY

NPI 1992941694 · NPPES record last updated Nov 20, 2010

Key facts

NPI
1992941694
Entity type
Individual (NPI type 1)
Primary specialty
Surgical Assistant 246ZC0007X
License
SA177 (KY)
Practice address
101 E Garnettsville Rd
Muldraugh, KY 40155-1137
Phone
(502) 938-8691
NPI assigned
Dec 30, 2008
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
SA177KYMDSurgical Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Assistant 246ZC0007X SA177 KY Yes

Addresses

Primary practice location

101 E Garnettsville Rd
Muldraugh, KY 40155-1137

Mailing address

101 E Garnettsville Rd
Muldraugh, KY 40155-1137
Phone (502) 938-8691

Sources for this page

Verify at the official NPI Registry.