Provider Demographics
NPI:1316032519
Name:HUBBS, LARRY JOSEPH (ARNP)
Entity Type:Individual
Prefix:MR
First Name:LARRY
Middle Name:JOSEPH
Last Name:HUBBS
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:152 MOCKINGBIRD HILL DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-8007
Mailing Address - Country:US
Mailing Address - Phone:859-582-1536
Mailing Address - Fax:
Practice Address - Street 1:2108 NICHOLASVILLE RD # 100
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-2502
Practice Address - Country:US
Practice Address - Phone:859-278-9413
Practice Address - Fax:859-276-0715
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3004957363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY0576424Medicare PIN
KY0976309Medicare PIN
KY0650723Medicare PIN