Provider Demographics
NPI:1891701835
Name:HOBBS, ROBERT A JR (APRN)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:A
Last Name:HOBBS
Suffix:JR
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3012 EASTPOINT PKWY
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-4185
Mailing Address - Country:US
Mailing Address - Phone:502-365-4545
Mailing Address - Fax:502-365-4546
Practice Address - Street 1:3012 EASTPOINT PKWY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40223-4185
Practice Address - Country:US
Practice Address - Phone:502-365-4545
Practice Address - Fax:502-365-4546
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2019-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1096562163W00000X
KY3004876363L00000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100576100Medicaid
Q71252Medicare UPIN