Individual
LISA HUBBARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP
Contact information
Practice address
502 FARRELL DR, COVINGTON, KY 41011-3717
(859) 331-3292
(859) 578-2864
Mailing address
502 FARRELL DR, COVINGTON, KY 41011-3717
(859) 578-3204
(859) 578-3273
Taxonomy
Speciality
Code
Description
License number
State
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
Primary
1141553
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
610661458
TAX ID
KY
Enumeration date
10/17/2014
Last updated
10/17/2014
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