Provider Demographics
NPI:1518948967
Name:JEPSEN-HOBBS, CORINNE (APNP)
Entity Type:Individual
Prefix:MRS
First Name:CORINNE
Middle Name:
Last Name:JEPSEN-HOBBS
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:CORINNE
Other - Middle Name:
Other - Last Name:MUTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1621 N TAYLOR DR
Mailing Address - Street 2:
Mailing Address - City:SHEBOYGAN
Mailing Address - State:WI
Mailing Address - Zip Code:53081-1990
Mailing Address - Country:US
Mailing Address - Phone:920-458-7433
Mailing Address - Fax:920-452-3594
Practice Address - Street 1:1621 N TAYLOR DR
Practice Address - Street 2:
Practice Address - City:SHEBOYGAN
Practice Address - State:WI
Practice Address - Zip Code:53081-1990
Practice Address - Country:US
Practice Address - Phone:920-458-7433
Practice Address - Fax:920-452-3594
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1984033363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41177000Medicaid
WI41177000Medicaid