Healthcare Provider Details

I. General information

NPI: 1649380106
Provider Name (Legal Business Name): JULIA HUBBARD PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 08/08/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

736 BATTLEFIELD BLVD N CHESAPEAKE GENERAL HOSPITAL
CHESAPEAKE VA
23320-4941
US

IV. Provider business mailing address

109G GAINSBOROUGH SQ BOX 723
CHESAPEAKE VA
23320
US

V. Phone/Fax

Practice location:
  • Phone: 757-312-6200
  • Fax: 757-312-6181
Mailing address:
  • Phone: 757-490-9388
  • Fax: 757-490-9401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number0110840727
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0110840727
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: