Provider Demographics
NPI:1962650713
Name:HUBBARD, SHONNIE L (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:SHONNIE
Middle Name:L
Last Name:HUBBARD
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 516
Mailing Address - Street 2:
Mailing Address - City:ALBERTVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35950-0008
Mailing Address - Country:US
Mailing Address - Phone:256-878-1053
Mailing Address - Fax:256-878-9969
Practice Address - Street 1:US HIGHWAY 431
Practice Address - Street 2:STE 11
Practice Address - City:ALBERTVILLE
Practice Address - State:AL
Practice Address - Zip Code:35950-2049
Practice Address - Country:US
Practice Address - Phone:256-878-1053
Practice Address - Fax:256-878-9969
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-05
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-059298363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily