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Individual
MARIEL HUBBARD
Active
Individual
MARIEL HUBBARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
R880070
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08706760
—
MS
05
—
2406361
—
LA
Enumeration date
09/17/2012
Last updated
07/30/2020
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