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Individual

SCOTT E HUBBARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
10415 WALLACE ALLEY ST, KINGSPORT, TN 37663-3936
(423) 390-0451
Mailing address
10415 WALLACE ALLEY ST, KINGSPORT, TN 37663-3936
(423) 390-0451

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
10807
TN
367500000X
Certified Registered Nurse Anesthetist
RN0000096922
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3628726
TN
Enumeration date
08/25/2005
Last updated
02/11/2025
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