Provider Demographics
NPI:1821889874
Name:HUBBARD, DOUGLAS S (BSN,RN)
Entity type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:S
Last Name:HUBBARD
Suffix:
Gender:M
Credentials:BSN,RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8725 W SHADY LN
Mailing Address - Street 2:
Mailing Address - City:HULBERT
Mailing Address - State:OK
Mailing Address - Zip Code:74441-1958
Mailing Address - Country:US
Mailing Address - Phone:918-351-9785
Mailing Address - Fax:918-577-3892
Practice Address - Street 1:8725 W SHADY LN
Practice Address - Street 2:
Practice Address - City:HULBERT
Practice Address - State:OK
Practice Address - Zip Code:74441-1958
Practice Address - Country:US
Practice Address - Phone:918-351-9785
Practice Address - Fax:918-577-3892
Is Sole Proprietor?:No
Enumeration Date:2025-05-16
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK0094588163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management