Provider Demographics
NPI:1912277328
Name:HUBBARD, KRISTINA E (MA)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:E
Last Name:HUBBARD
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8060 MEADOW VISTA DR
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-1073
Mailing Address - Country:US
Mailing Address - Phone:619-573-2604
Mailing Address - Fax:
Practice Address - Street 1:701 S CARSON ST
Practice Address - Street 2:SUITE 200
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89701-5262
Practice Address - Country:US
Practice Address - Phone:775-461-0551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-03
Last Update Date:2012-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker