Provider Demographics
NPI:1407355522
Name:HUBINGER, SCOTT (NP-C)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:HUBINGER
Suffix:
Gender:M
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11700 WALDRON RD
Mailing Address - Street 2:
Mailing Address - City:WALDRON
Mailing Address - State:MI
Mailing Address - Zip Code:49288-9654
Mailing Address - Country:US
Mailing Address - Phone:517-286-6685
Mailing Address - Fax:
Practice Address - Street 1:168 S HOWELL ST
Practice Address - Street 2:
Practice Address - City:HILLSDALE
Practice Address - State:MI
Practice Address - Zip Code:49242-2040
Practice Address - Country:US
Practice Address - Phone:517-437-4451
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-04
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704215462363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner