Doctor Name: | NICHOLE A HUBBARD |
NPI Number: | 1003813197 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA |
License Number: | 50001377 |
Business Practice Address: | 2142 N Cove Blvd Toledo, OH - 436063895 |
Business Phone Number: | 4192915318 |
Business Fax Number: | 4192916430 |
Mailing Address: | 2142 N Cove Blvd, TOLEDO |
State: | OH |
Postal Code: | 436063895 |
Phone Number: | 4192915318 |
Fax Number: | 4192916430 |
NPI Enumeration Date: | 07/05/2005 |
NPI Last Update Date: | 12/27/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 50001377 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |