Provider Demographics
NPI:1093709321
Name:HOBBS, MICHAEL TRENT (CNP)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:TRENT
Last Name:HOBBS
Suffix:
Gender:M
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8927 S MYSTIC MEADOW RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85756-6172
Mailing Address - Country:US
Mailing Address - Phone:520-308-0934
Mailing Address - Fax:
Practice Address - Street 1:5369 S CALLE SANTA CRUZ
Practice Address - Street 2:SUITE 145
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85706-3963
Practice Address - Country:US
Practice Address - Phone:520-573-7500
Practice Address - Fax:520-573-7557
Is Sole Proprietor?:No
Enumeration Date:2005-09-01
Last Update Date:2017-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR43004363LF0000X
AZAP3865363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
343510800Medicare ID - Type Unspecified
Q40589Medicare UPIN