Provider Demographics
NPI:1558103598
Name:HOBBS, BRENDA LEE (RN)
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:LEE
Last Name:HOBBS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22823 S MALLOY PRAIRIE RD
Mailing Address - Street 2:
Mailing Address - City:CHENEY
Mailing Address - State:WA
Mailing Address - Zip Code:99004-7009
Mailing Address - Country:US
Mailing Address - Phone:360-503-8208
Mailing Address - Fax:
Practice Address - Street 1:22823 S MALLOY PRAIRIE RD
Practice Address - Street 2:
Practice Address - City:CHENEY
Practice Address - State:WA
Practice Address - Zip Code:99004-7009
Practice Address - Country:US
Practice Address - Phone:360-503-8208
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-11
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ302748163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health