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General NPI Number Information
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NPI Number | 1417428715
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Entity Type | Individual
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Provider Name | LAURA JAYNE HUBBS PA-C
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Gender | Female
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Dates
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Enumeration Date | 12/12/2018
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Last Update Date | 01/22/2024
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Provider Practice Location Address
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Address Line | 6275 E VIRGINIA BEACH BLVD STE 303
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City | NORFOLK
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State | VA
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Zip | 23502-2851
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Country | US
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Telephone | 757-461-3141
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Fax |
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Provider Business Mailing Address
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Address Line | 6275 E VIRGINIA BEACH BLVD STE 303
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City | NORFOLK
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State | VA
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Zip | 23502-2851
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Country | US
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Telephone | 203-688-4242
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 5174
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | 0110008625
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License Number State | VA
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