Provider Demographics
NPI:1982854782
Name:HOBERG, MARGARET JEAN (NP)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:JEAN
Last Name:HOBERG
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1702 UNIVERSITY DR S-SSC
Mailing Address - Street 2:MEDICAL STAFF SERVICE
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-4940
Mailing Address - Country:US
Mailing Address - Phone:218-606-9396
Mailing Address - Fax:701-364-8476
Practice Address - Street 1:400 EAST 3RD STREET
Practice Address - Street 2:SMDC MEDICAL CENTER-DULUTH CLINIC
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55805
Practice Address - Country:US
Practice Address - Phone:218-786-1216
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-29
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR152213-4363LG0600X, 363LA2200X
WI3799-33363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1982854782Medicaid
MN1982854782Medicaid
MN1982854782Medicaid