Provider Demographics
NPI:1336929421
Name:HOBBICK, STACEY (DNP, MSN-ED, RN,)
Entity Type:Individual
Prefix:DR
First Name:STACEY
Middle Name:
Last Name:HOBBICK
Suffix:
Gender:F
Credentials:DNP, MSN-ED, RN,
Other - Prefix:
Other - First Name:STACEY
Other - Middle Name:
Other - Last Name:HUTCHISON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:936 S FOREST CREEK DR
Mailing Address - Street 2:
Mailing Address - City:SAINT AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32092-0755
Mailing Address - Country:US
Mailing Address - Phone:980-328-4403
Mailing Address - Fax:
Practice Address - Street 1:936 S FOREST CREEK DR
Practice Address - Street 2:
Practice Address - City:SAINT AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32092-0755
Practice Address - Country:US
Practice Address - Phone:980-328-4403
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-05
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95177865163W00000X
FLRN9521751163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse