Provider Demographics
NPI:1811454291
Name:HUBBARD, CADY DANIELLE (DNP, APRN, CPNP-PC)
Entity type:Individual
Prefix:MS
First Name:CADY
Middle Name:DANIELLE
Last Name:HUBBARD
Suffix:
Gender:
Credentials:DNP, APRN, CPNP-PC
Other - Prefix:
Other - First Name:CADY
Other - Middle Name:
Other - Last Name:BURCHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:850 POPLAR AVE BLDG 2
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38105-4607
Mailing Address - Country:US
Mailing Address - Phone:901-287-7337
Mailing Address - Fax:
Practice Address - Street 1:51 N DUNLAP ST
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38105-4625
Practice Address - Country:US
Practice Address - Phone:901-287-7337
Practice Address - Fax:901-287-4535
Is Sole Proprietor?:No
Enumeration Date:2019-02-21
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY382949363LP0200X
TN26447363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ054367Medicaid
MS00980298Medicaid
AR238276758Medicaid