Provider Demographics
NPI:1720425630
Name:HOBBS, CHERYL LYNN (FNP-C)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:LYNN
Last Name:HOBBS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2900 SAINT MICHAEL DR STE 401
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75503-5211
Mailing Address - Country:US
Mailing Address - Phone:903-614-5367
Mailing Address - Fax:903-614-5343
Practice Address - Street 1:8445 MEMORIAL BLVD STE 500
Practice Address - Street 2:
Practice Address - City:PORT ARTHUR
Practice Address - State:TX
Practice Address - Zip Code:77640
Practice Address - Country:US
Practice Address - Phone:409-982-6461
Practice Address - Fax:409-938-7461
Is Sole Proprietor?:No
Enumeration Date:2013-05-31
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP123679363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX318127708Medicaid
TX348127709Medicaid
TX1K1840OtherMEDICARE
TXP02601540OtherMCRR
TX1K1841OtherMEDICARE