Nicholas James Hubbard
Individual provider Active NPI Athletic Trainer · Suamico, WI
NPI 1679951248 · NPPES record last updated May 14, 2015
Key facts
- NPI
- 1679951248
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- Practice address
- 2132 Cathedral Forest Dr
Suamico, WI 54313-7680 - Phone
- (920) 615-4887
- NPI assigned
- May 14, 2015
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | Yes | ||
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
2132 Cathedral Forest Dr
Suamico, WI 54313-7680
Mailing address
2132 Cathedral Forest Dr
Suamico, WI 54313-7680
Other providers in Suamico, WI
- Cathy Devalk-Holl
- Devoted Transport LLC
- Jamey Marie Francar
- Tyler Guist
- Stephanie Ann Hammar
- Miriah Ison
- Jill Renea Jahnke
- Dylan Edward James
- Jeffrey P Winick MD a Professional Corp
- John Joseph Companies
All providers in Suamico, WI · Athletic Trainer in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 14, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.