Provider Demographics
NPI:1881358877
Name:HUBBARD, MARQUITA RENE (LPN)
Entity type:Individual
Prefix:MISS
First Name:MARQUITA
Middle Name:RENE
Last Name:HUBBARD
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:922 13TH ST
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23607-6422
Mailing Address - Country:US
Mailing Address - Phone:757-921-6876
Mailing Address - Fax:757-257-0775
Practice Address - Street 1:922 13TH ST
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23607-6422
Practice Address - Country:US
Practice Address - Phone:757-921-6876
Practice Address - Fax:757-257-0775
Is Sole Proprietor?:No
Enumeration Date:2021-10-26
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0002074806164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse