Individual
JEREMY RAY HUBBARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
728 W SHERROD AVE, COVINGTON, TN 38019-3024
(901) 476-7779
(901) 475-6008
Mailing address
234 LAKE DRIVE, RIPLEY, TN 38063
(731) 671-5620
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
23230
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q038660
—
TN
Enumeration date
09/16/2017
Last updated
12/28/2018
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