Provider Demographics
NPI:1508045204
Name:HOBSON, SHANTEL LAURA (LPN)
Entity Type:Individual
Prefix:
First Name:SHANTEL
Middle Name:LAURA
Last Name:HOBSON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9280 N MANILA RD
Mailing Address - Street 2:
Mailing Address - City:BENNETT
Mailing Address - State:CO
Mailing Address - Zip Code:80102-9585
Mailing Address - Country:US
Mailing Address - Phone:303-210-4956
Mailing Address - Fax:
Practice Address - Street 1:2100 BROADWAY
Practice Address - Street 2:2ND FLOOR
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80205-2526
Practice Address - Country:US
Practice Address - Phone:303-296-4996
Practice Address - Fax:303-296-4436
Is Sole Proprietor?:No
Enumeration Date:2007-10-30
Last Update Date:2007-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPN-43347164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse