Provider Demographics
NPI:1689990418
Name:HOBART, DIANNA LYNNE (LPN IV)
Entity Type:Individual
Prefix:
First Name:DIANNA
Middle Name:LYNNE
Last Name:HOBART
Suffix:
Gender:F
Credentials:LPN IV
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 MAROY DR.
Mailing Address - Street 2:
Mailing Address - City:SOUTH. AMHERST
Mailing Address - State:OH
Mailing Address - Zip Code:44001-2840
Mailing Address - Country:US
Mailing Address - Phone:440-986-2115
Mailing Address - Fax:
Practice Address - Street 1:118 MAROY DR.
Practice Address - Street 2:
Practice Address - City:SOUTH AMHERST
Practice Address - State:OH
Practice Address - Zip Code:44001-2840
Practice Address - Country:US
Practice Address - Phone:440-986-2115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-19
Last Update Date:2010-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN. 120271 IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse