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General NPI Number Information
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NPI Number | 1164031985
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Entity Type | Individual
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Provider Name | REBECCA VIOLET HUBBARD APRN
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Gender | Female
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Dates
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Enumeration Date | 07/28/2020
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Last Update Date | 07/07/2022
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Provider Practice Location Address
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Address Line | 1000 POLE CREEK XING
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City | SIDNEY
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State | NE
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Zip | 69162-2901
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Country | US
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Telephone | 308-254-2825
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Fax |
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Provider Business Mailing Address
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Address Line | 14544 ROAD 26
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City | LODGEPOLE
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State | NE
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Zip | 69149-5058
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Country | US
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Telephone | 308-765-2489
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 114274
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | NULL
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 71707
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License Number State | NE
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