Individual
KIMBERLY LEE HUBBARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP-BC
Contact information
Practice address
4411 MEDICAL DR STE 300, SAN ANTONIO, TX 78229-3824
(210) 614-5400
(210) 614-2413
Mailing address
4411 MEDICAL DR STE 300, SAN ANTONIO, TX 78229-3824
(210) 614-5400
(210) 614-4244
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP13813
TX
363LA2100X
Acute Care Nurse Practitioner
AP138913
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
814442
MCR PTAN
TX
Enumeration date
08/11/2018
Last updated
02/10/2022
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