MEDICARE: KATHRYN JOANN HUBBARD APN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	APN.0993939-NP	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0993939	OTHER	CO	APN

General Provider Information

NPI Number	:	1073099156
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHRYN JOANN HUBBARD APN

Provider Business Mailing Address
First Line	:	7954 NATIVE DANCER TRL
Second Line	:
City	:	EVERGREEN
State	:	CO
Zip	:	80439-6470
Country	:	US
Telephone Number	:	720-401-7220
Fax Number	:

Provider Business Practice Location Address
First Line	:	3455 RINGSBY CT STE 102
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80216-4923
Country	:	US
Telephone Number	:	720-642-1125
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2018
Last Update Date	:	04/23/2025

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