Provider Demographics
NPI:1356638266
Name:HUBBELL, SARA MARIE (ARNP)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:MARIE
Last Name:HUBBELL
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:830 4TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52403-2423
Mailing Address - Country:US
Mailing Address - Phone:319-362-5118
Mailing Address - Fax:319-364-0574
Practice Address - Street 1:830 4TH AVE SE
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52403-2423
Practice Address - Country:US
Practice Address - Phone:319-362-5118
Practice Address - Fax:319-364-0574
Is Sole Proprietor?:No
Enumeration Date:2011-06-30
Last Update Date:2011-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA118413363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA118413OtherLICENSE