Provider Demographics
NPI:1821337924
Name:HOOBLER, REBECCAH
Entity Type:Individual
Prefix:
First Name:REBECCAH
Middle Name:
Last Name:HOOBLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2416 18TH ST S
Mailing Address - Street 2:APT 303
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-5176
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2416 18TH ST S
Practice Address - Street 2:APT 303
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-5176
Practice Address - Country:US
Practice Address - Phone:701-373-5858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-08
Last Update Date:2013-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR38036163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse