Provider Demographics
NPI:1538841838
Name:WYATT-HOBBS, MARIA R (RN, CCM)
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:R
Last Name:WYATT-HOBBS
Suffix:
Gender:F
Credentials:RN, CCM
Other - Prefix:MS
Other - First Name:MARIA
Other - Middle Name:R
Other - Last Name:BRYANT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:1501 S. CLINTON STREET, BALTIMORE, MD 21224
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224
Mailing Address - Country:US
Mailing Address - Phone:855-444-3121
Mailing Address - Fax:
Practice Address - Street 1:1501 S CLINTON ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-5730
Practice Address - Country:US
Practice Address - Phone:855-444-3121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-04
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR146157163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management