Provider Demographics
NPI:1174297170
Name:HUBBARD, CHELSEA FAYE (CRNA)
Entity Type:Individual
Prefix:MS
First Name:CHELSEA
Middle Name:FAYE
Last Name:HUBBARD
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:CHELSEA
Other - Middle Name:FAYE
Other - Last Name:RASMUSSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1014 E 13TH AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99202-2526
Mailing Address - Country:US
Mailing Address - Phone:503-913-7921
Mailing Address - Fax:
Practice Address - Street 1:2003 KOOTENAI HEALTH WAY
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-6051
Practice Address - Country:US
Practice Address - Phone:208-625-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-03
Last Update Date:2024-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61518279367500000X
ID53768367500000X
WARN60716381163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse