Healthcare Provider Details

I. General information

NPI: 1710563929
Provider Name (Legal Business Name): JAMESE HUBBARD RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/19/2021
Last Update Date: 03/19/2021
Certification Date: 03/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1653 EDEN PARK DR APT 11
HAMILTON OH
45013-5517
US

IV. Provider business mailing address

1653 EDEN PARK DR APT 11
HAMILTON OH
45013-5517
US

V. Phone/Fax

Practice location:
  • Phone: 513-739-9112
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number387387
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: