Provider Demographics
NPI:1699135988
Name:HUBBERT, DENISE (FNP-C)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:HUBBERT
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4057 RILEY FUZZEL ROAD BUILDING 700 SUITE #405
Mailing Address - Street 2:
Mailing Address - City:NEW WAVERLY
Mailing Address - State:TX
Mailing Address - Zip Code:77358
Mailing Address - Country:US
Mailing Address - Phone:281-907-0513
Mailing Address - Fax:281-529-7560
Practice Address - Street 1:4057 RILEY FUZZEL RD
Practice Address - Street 2:BUILDING 700, SUITE #405
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77386-4632
Practice Address - Country:US
Practice Address - Phone:281-900-1281
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-29
Last Update Date:2021-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX714036363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily