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Individual

AMBRIANA SIMONE HUBBARD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHARMD

Contact information

Practice address
3634 REYNOLDA RD, WINSTON SALEM, NC 27106-2230
(336) 923-2367
Mailing address
5801 HEARTHWOOD CT APT B, WINSTON SALEM, NC 27105-1241
(843) 337-9208

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
30266
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
30266
NC PHARMACIST LICENSE
NC
Enumeration date
03/16/2021
Last updated
03/16/2021
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