Provider Demographics
NPI:1902297302
Name:HUBBERT, DANNIELLE
Entity type:Individual
Prefix:MS
First Name:DANNIELLE
Middle Name:
Last Name:HUBBERT
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3200 BELMONT AVE STE 8
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44505-1862
Mailing Address - Country:US
Mailing Address - Phone:330-775-7759
Mailing Address - Fax:
Practice Address - Street 1:3200 BELMONT AVE STE 8
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44505-1862
Practice Address - Country:US
Practice Address - Phone:330-775-7759
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-07
Last Update Date:2025-02-24
Deactivation Date:2023-12-19
Deactivation Code:
Reactivation Date:2025-02-20
Provider Licenses
StateLicense IDTaxonomies
OHRN.440921163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty