Provider Demographics
NPI:1316357643
Name:HUBBARD, ABBY (CRNP)
Entity Type:Individual
Prefix:
First Name:ABBY
Middle Name:
Last Name:HUBBARD
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:ABBY
Other - Middle Name:
Other - Last Name:CUMMINGS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5112 W. TAFT RD.
Mailing Address - Street 2:STE J
Mailing Address - City:LIVERPOOL
Mailing Address - State:NY
Mailing Address - Zip Code:13088
Mailing Address - Country:US
Mailing Address - Phone:315-701-2170
Mailing Address - Fax:
Practice Address - Street 1:5112 W. TAFT RD.
Practice Address - Street 2:STE J
Practice Address - City:LIVERPOOL
Practice Address - State:NY
Practice Address - Zip Code:13088
Practice Address - Country:US
Practice Address - Phone:315-701-2170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-08
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY338003363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily