Provider Demographics
NPI:1346520632
Name:HUBBARD, LAURA M (BSN, MSN, ARNP,NNP-C)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:M
Last Name:HUBBARD
Suffix:
Gender:F
Credentials:BSN, MSN, ARNP,NNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2718 N ORANGE AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-7611
Mailing Address - Country:US
Mailing Address - Phone:407-303-2578
Mailing Address - Fax:407-303-8279
Practice Address - Street 1:601 E ROLLINS ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-1248
Practice Address - Country:US
Practice Address - Phone:407-303-2578
Practice Address - Fax:407-303-8279
Is Sole Proprietor?:No
Enumeration Date:2011-08-18
Last Update Date:2012-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9218742163WN0002X
FLARNP9218742363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal
No163WN0002XNursing Service ProvidersRegistered NurseNeonatal Intensive Care