| Doctor Name: | KELLY JO HUBBARD |
| NPI Number: | 1780990408 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APN |
| License Number: | AO3428 ANP |
| Business Practice Address: | 9755 W State Highway 22 Ratcliff, AR - 729519000 |
| Business Phone Number: | 4796355300 |
| Business Fax Number: | 4796352010 |
| Mailing Address: | Po Box 130, RATCLIFF |
| State: | AR |
| Postal Code: | 729510130 |
| Phone Number: | 4796355300 |
| Fax Number: | 4796352010 |
| NPI Enumeration Date: | 08/19/2010 |
| NPI Last Update Date: | 08/08/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | AO3428 ANP |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AR |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |