Provider Demographics
NPI:1114496478
Name:CHUBB, BARBARA ANN (APN)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:ANN
Last Name:CHUBB
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:626 PROSPECT ST
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07040-2724
Mailing Address - Country:US
Mailing Address - Phone:973-763-3009
Mailing Address - Fax:
Practice Address - Street 1:626 PROSPECT ST
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07040-2724
Practice Address - Country:US
Practice Address - Phone:973-763-3009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-16
Last Update Date:2018-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00873100363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily