Provider Demographics
NPI:1629709100
Name:HOBSON, KRISTA RAYNES (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:KRISTA
Middle Name:RAYNES
Last Name:HOBSON
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8399 HIGHWAY 16
Mailing Address - Street 2:
Mailing Address - City:SENOIA
Mailing Address - State:GA
Mailing Address - Zip Code:30276-3139
Mailing Address - Country:US
Mailing Address - Phone:404-849-7180
Mailing Address - Fax:
Practice Address - Street 1:8399 HIGHWAY 16
Practice Address - Street 2:
Practice Address - City:SENOIA
Practice Address - State:GA
Practice Address - Zip Code:30276-3139
Practice Address - Country:US
Practice Address - Phone:404-849-7180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-23
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN183664363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health