MARIEL HUBBARD (NPI# 1083964092) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083964092 |
| Entity Type | Individual |
| Full Name | MARIEL HUBBARD |
| Credential | CPNP |
| Practice Address |
101 Medical Park Hattiesburg MS 39401-9042 |
| Mailing Address |
415 S 28th Ave Hattiesburg MS 39401-7246 |
| Practice Telephone | 6015793000 |
| Practice Fax Number | 6015844727 |
| Mailing Telephone | 6015793000 |
| Mailing Fax Number | 6015795463 |
| Enumeration Date | 2012-09-17 |
| Last Update Date | 2020-07-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
R880070 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 08706760 | 05 | |
| LA | 2406361 | 05 |
| Street Address |
101 MEDICAL PARK |
| City | HATTIESBURG |
| State | MS |
| Zip Code | 39401-9042 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417466079 | Leslie Rollins | Nurse Practitioner | 101 Medical Park, Hattiesburg, MS 39401 | 2017-09-27 |
| 1578095238 | Kristen Nicole Ramey | Pediatrics | 101 Medical Park, Hattiesburg, MS 39401-9042 | 2017-03-31 |
| 1184037038 | Mary Perez | Pediatrics | 101 Medical Park, Hattiesburg, MS 39401 | 2014-06-09 |
| 1982803862 | William Brent Bowling | Pediatrics | 101 Medical Park, Hattiesburg, MS 39401 | 2007-07-12 |
| 1497837801 | Hattiesburg Clinic Pa | Pediatrics | 101 Medical Park, Hattiesburg, MS 39401 | 2006-10-19 |
| 1881703445 | Jonathan W Shook | Pediatrics | 101 Medical Park, Hattiesburg, MS 39401 | 2006-08-29 |
| 1871601070 | Brenton G Richardson | Pediatrics | 101 Medical Park, Hattiesburg, MS 39401 | 2006-08-28 |
| 1376658518 | Gregory W Merritt | Pediatrics | 101 Medical Park, Hattiesburg, MS 39401 | 2006-08-20 |
| 1750494472 | Anita S Henderson | Pediatrics | 101 Medical Park, Hattiesburg, MS 39401 | 2006-08-16 |
| 1255348645 | Scott G Burks | Pediatrics | 101 Medical Park, Hattiesburg, MS 39401 | 2006-08-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598315863 | Lisa Thornton | Technician | 18 Timberline Dr., Hattiesburg, MS 39401 | 2019-09-18 |
| 1548813637 | Caroline Estes Barnes | Counselor | Barnes, 8 App Slade Road, Hattiesburg, MS 39401 | 2019-07-18 |
| 1396252441 | Selection Healthcare Services, LLC | In Home Supportive Care | 606 Adeline St Ste 1c, Hattiesburg, MS 39401 | 2018-01-10 |
| 1225545585 | Whitney Wilkinson | Nurse Practitioner | 301 South 28th Avenue, Hattiesburg, MS 39401 | 2018-01-08 |
| 1740795806 | Forrest General Hospital | Pharmacy | 1414 South 28th Avenue, Hattiesburg, MS 39401 | 2017-12-11 |
| 1275058455 | Casey Payne | Pharmacist | 6130 Us 49, Hattiesburg, MS 39401 | 2017-08-08 |
| 1225562705 | Sarah Marie Hudson | Family Medicine | 6051 Us Highway 49 S, Hattiesburg, MS 39401 | 2017-04-12 |
| 1043671704 | The Covington's Cove Assisted Living Center LLC | Assisted Living Facility | 192 Mary Magdalene Church Rd, Hattiesburg, MS 39401 | 2016-03-09 |
| 1780083626 | Dominique Reed Watson | Pharmacist | 602 Adeline St, Hattiesburg, MS 39401 | 2014-08-15 |
| 1558778936 | Willie Davis Jr. | Day Training, Developmentally Disabled Services | 701 Duke Ave., Hattiesbiurg, MS 39401 | 2014-07-17 |
| Find all providers in zip 39401 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821697210 | Katie Scianna Moore | Nurse Practitioner | 4210 Lincoln Rd, Hattiesburg, MS 39402-3093 | 2020-10-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376142943 | Ashley B Chittenden | Nurse Practitioner | 3480 Avis Ln, Southaven, MS 38672-2010 | 2020-10-23 |
| 1437760881 | Elizabeth Smith | Nurse Practitioner | 3631 Bienville Blvd Ste A, Ocean Springs, MS 39564-5702 | 2020-08-10 |
| 1750879003 | Heather Lynn Theisen | Nurse Practitioner | 15190 Community Rd Ste 330, Gulfport, MS 39503 | 2018-04-23 |
| 1972021608 | Dana Brooke Underwood | Nurse Practitioner | 1300 Access Rd Ste 400, Oxford, MS 38655-5211 | 2017-09-01 |
| 1891233276 | Optimum Healthcare Associates, Pa | Nurse Practitioner | 5350 Executive Pl, Suite 8, Jackson, MS 39206-4100 | 2017-02-06 |
| 1386020113 | Stefanie Taylor Christy | Nurse Practitioner | 3654b New Hope Rd, Columbus, MS 39702-8521 | 2015-08-04 |
| 1861808974 | Ashley Hickman | Nurse Practitioner | 224 S Church St Ste B, Brookhaven, MS 39601-3232 | 2014-07-09 |
| 1528486289 | Thomas Stallworth | Nurse Practitioner | 4105 Hospital St Ste 104, Pascagoula, MS 39581 | 2014-03-31 |
| 1962744482 | Kendra Watts | Nurse Practitioner | 1016 Sixth Ave Ste C, Picayune, MS 39466-3861 | 2013-03-22 |
| 1730340563 | Kayti A Powell | Nurse Practitioner | 1488 Hwy 487 East, Sebastopol, MS 39359-0150 | 2008-06-24 |
| Find all providers with the same taxonomy | ||||
| City | HATTIESBURG |
| Zip Code | 39401 |
Please comment or provide details below to improve the information on MARIEL HUBBARD.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.