Provider Demographics
NPI:1891871836
Name:HUBBARD, SARAH B (PA)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:B
Last Name:HUBBARD
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:5855 BREMO RD
Mailing Address - Street 2:SUITE 509
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-1930
Mailing Address - Country:US
Mailing Address - Phone:804-977-8920
Mailing Address - Fax:804-282-2918
Practice Address - Street 1:5855 BREMO RD
Practice Address - Street 2:SUITE 509
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-1930
Practice Address - Country:US
Practice Address - Phone:804-977-8920
Practice Address - Fax:804-282-2918
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2015-01-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0110001914363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010125405 541581185Medicaid
VAC06778OtherGROUP PTAN
VAP09417Medicare UPIN