Provider Demographics
NPI:1922234442
Name:HULBERT, JEAN (DC, LAC)
Entity Type:Individual
Prefix:DR
First Name:JEAN
Middle Name:
Last Name:HULBERT
Suffix:
Gender:F
Credentials:DC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3341 FAIRBANKS ST
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-4145
Mailing Address - Country:US
Mailing Address - Phone:907-339-0330
Mailing Address - Fax:907-339-0331
Practice Address - Street 1:3341 FAIRBANKS ST
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503
Practice Address - Country:US
Practice Address - Phone:907-433-9629
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-10
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKCHIC523111N00000X
AKACUA126171100000X
MN3339111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNU93537Medicare UPIN