Provider Demographics
NPI:1558300780
Name:HOBERT, DEANNE M (APN)
Entity Type:Individual
Prefix:
First Name:DEANNE
Middle Name:M
Last Name:HOBERT
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3900 28TH AVENUE DR
Mailing Address - Street 2:
Mailing Address - City:MOLINE
Mailing Address - State:IL
Mailing Address - Zip Code:61265-5536
Mailing Address - Country:US
Mailing Address - Phone:309-281-2840
Mailing Address - Fax:
Practice Address - Street 1:3900 28TH AVENUE DR
Practice Address - Street 2:
Practice Address - City:MOLINE
Practice Address - State:IL
Practice Address - Zip Code:61265-5536
Practice Address - Country:US
Practice Address - Phone:309-281-2840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041-254207363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
1740349034OtherGROUP NPI
1740349034OtherGROUP NPI
IL305250Medicare PIN
IA56266Medicare PIN