Provider Demographics
NPI:1396509907
Name:HUBBARD, SIERRA A
Entity type:Individual
Prefix:
First Name:SIERRA
Middle Name:A
Last Name:HUBBARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4274 NC 704 HWY E
Mailing Address - Street 2:
Mailing Address - City:SANDY RIDGE
Mailing Address - State:NC
Mailing Address - Zip Code:27046-7647
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4274 NC 704 HWY E
Practice Address - Street 2:
Practice Address - City:SANDY RIDGE
Practice Address - State:NC
Practice Address - Zip Code:27046-7647
Practice Address - Country:US
Practice Address - Phone:336-402-3255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-13
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant