Provider Demographics
NPI:1578907168
Name:HUBBARD, CHRISTY L (RN)
Entity Type:Individual
Prefix:
First Name:CHRISTY
Middle Name:L
Last Name:HUBBARD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 ROOSEVELT AVE
Mailing Address - Street 2:#1
Mailing Address - City:STAMFORD
Mailing Address - State:NY
Mailing Address - Zip Code:12167-1124
Mailing Address - Country:US
Mailing Address - Phone:607-652-7125
Mailing Address - Fax:607-652-7125
Practice Address - Street 1:24 ROOSEVELT AVE
Practice Address - Street 2:#1
Practice Address - City:STAMFORD
Practice Address - State:NY
Practice Address - Zip Code:12167-1124
Practice Address - Country:US
Practice Address - Phone:607-652-7125
Practice Address - Fax:607-652-7125
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-25
Last Update Date:2013-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY648257-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse