Provider Demographics
NPI:1467565036
Name:HOBUS, PEGGY SUE (APRN)
Entity Type:Individual
Prefix:
First Name:PEGGY
Middle Name:SUE
Last Name:HOBUS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 N CHESTNUT ST
Mailing Address - Street 2:PO BOX 342
Mailing Address - City:AVOCA
Mailing Address - State:IA
Mailing Address - Zip Code:51521-5142
Mailing Address - Country:US
Mailing Address - Phone:402-680-9564
Mailing Address - Fax:
Practice Address - Street 1:2510 BELLEVUE MEDICAL CENTER DR STE 145A
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68123-1556
Practice Address - Country:US
Practice Address - Phone:402-779-7207
Practice Address - Fax:402-779-7210
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2022-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA081496363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA02063OtherWELLMARK
NE10025347100Medicaid
IA1475152Medicaid
IA247897OtherMIDLANDS CHOICE
I16188Medicare ID - Type Unspecified
Q53485Medicare UPIN