Basic Information
| Provider Information | |||||||||
| NPI: | 1932450756 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HOBBS | ||||||||
| FirstName: | TIFFANY | ||||||||
| MiddleName: | ALLEN | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | NP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 513 GEORGIA AVE STE 114 | ||||||||
| Address2: | |||||||||
| City: | CHATTANOOGA | ||||||||
| State: | TN | ||||||||
| PostalCode: | 374033402 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4235315555 | ||||||||
| FaxNumber: | 4235316565 | ||||||||
| Practice Location | |||||||||
| Address1: | 513 GEORGIA AVE | ||||||||
| Address2: | |||||||||
| City: | CHATTANOOGA | ||||||||
| State: | TN | ||||||||
| PostalCode: | 374033402 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4235315555 | ||||||||
| FaxNumber: | 4235316565 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/20/2012 | ||||||||
| LastUpdateDate: | 12/17/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | 12/17/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WH1000X | 150283 | TN | N | Nursing Service Providers | Registered Nurse | Hospice | 163WH1000X | 16840 | TN | N | Nursing Service Providers | Registered Nurse | Hospice | 363L00000X | 16840 | TN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
ID Information
| ID | Type | State | Issuer | Description | 003109552A | 05 | TN | MEDICAID |