Provider Demographics
NPI:1467446617
Name:HUBLEY, BLANCHE (CRNA)
Entity Type:Individual
Prefix:MS
First Name:BLANCHE
Middle Name:
Last Name:HUBLEY
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:785 5TH AVENUE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-4232
Mailing Address - Country:US
Mailing Address - Phone:717-263-9555
Mailing Address - Fax:717-217-4217
Practice Address - Street 1:112 NORTH SEVENTH STREET
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-1720
Practice Address - Country:US
Practice Address - Phone:717-267-3000
Practice Address - Fax:717-217-4217
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-02
Last Update Date:2010-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN148188L367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARN148188LOtherRN LICENSE
PA253409OtherUNISON
PAP00458415OtherRAILROAD MEDICARE
PAPEARLOtherHEALTH AMERICA
PA120420418OtherDEPT OF LABOR
PA25-1716306OtherFIRST HEALTH
PA101960220 0001Medicaid
PA25-1716306OtherHEALTHNET/TRICARE
PA50073155OtherCAPITAL BLUECROSS
PA050514OtherGROUP MEDICARE #
PA101960220 0001Medicaid