Individual
LISA M HOBBY
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
450 MOUNTAIN VIEW ST, POWELL, WY 82435-2212
(307) 754-7257
(307) 754-7217
Mailing address
449 MOUNTAIN VIEW ST, POWELL, WY 82435-2232
(307) 754-4559
(307) 754-7733
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
141
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
312011
BLUE CROSS BLUE SHIELD
WY
05
—
4300609
—
MT
01
—
P00005496
RAILROAD MEDICARE
WY
Enumeration date
10/19/2005
Last updated
07/08/2007
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