Healthcare Provider Details

I. General information

NPI: 1619638509
Provider Name (Legal Business Name): MICHAELA ROWLAND HUBBARD PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MICHAELA ROWLAND ROSSI PA-C

II. Dates (important events)

Enumeration Date: 01/04/2022
Last Update Date: 07/07/2025
Certification Date: 07/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

661 INDEPENDENCE PKWY STE 120
CHESAPEAKE VA
23320-5114
US

IV. Provider business mailing address

ONE GI CREDENTIALING DEPARTMENT PO BOX 381468
GERMANTOWN TN
38183-6300
US

V. Phone/Fax

Practice location:
  • Phone: 757-547-0798
  • Fax: 757-547-0145
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0110008722
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: