Provider Demographics
NPI:1043527443
Name:HOBSON, AMANDA J (PA-C)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:J
Last Name:HOBSON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13431 OLD MERIDIAN ST
Mailing Address - Street 2:STE 200
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-1498
Mailing Address - Country:US
Mailing Address - Phone:317-573-7733
Mailing Address - Fax:317-573-7739
Practice Address - Street 1:13431 OLD MERIDIAN ST
Practice Address - Street 2:STE 200
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-1498
Practice Address - Country:US
Practice Address - Phone:317-573-7733
Practice Address - Fax:317-573-7739
Is Sole Proprietor?:No
Enumeration Date:2010-09-07
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN10001215A363A00000X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
INM400028702Medicare PIN