Provider Demographics
NPI:1528721453
Name:HOBBS, SHENANDOAH KELLY (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:SHENANDOAH
Middle Name:KELLY
Last Name:HOBBS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:SHENANDOAH
Other - Middle Name:KELLY
Other - Last Name:DORMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5616 BRAINERD RD STE 108
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37411-5377
Mailing Address - Country:US
Mailing Address - Phone:423-803-1379
Mailing Address - Fax:
Practice Address - Street 1:5616 BRAINERD RD STE 108
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37411-5377
Practice Address - Country:US
Practice Address - Phone:423-803-1379
Practice Address - Fax:855-699-6867
Is Sole Proprietor?:No
Enumeration Date:2021-10-18
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN30081363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily