Provider Demographics
NPI:1740663798
Name:HOBBS, JORDAN P (CNP)
Entity type:Individual
Prefix:
First Name:JORDAN
Middle Name:P
Last Name:HOBBS
Suffix:
Gender:M
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1652 GREENVIEW DR SW STE 160
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55902-4326
Mailing Address - Country:US
Mailing Address - Phone:507-328-0634
Mailing Address - Fax:612-567-4497
Practice Address - Street 1:1652 GREENVIEW DR SW STE 160
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55902-4326
Practice Address - Country:US
Practice Address - Phone:507-328-0634
Practice Address - Fax:612-567-4497
Is Sole Proprietor?:No
Enumeration Date:2015-07-08
Last Update Date:2022-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3965363LP0808X
MNCNP3965163WP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent