Provider Demographics
NPI:1871593855
Name:HUBBARD, CECELIA ANN (ARNP-C)
Entity type:Individual
Prefix:MRS
First Name:CECELIA
Middle Name:ANN
Last Name:HUBBARD
Suffix:
Gender:F
Credentials:ARNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2810 SILENTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CANTONMENT
Mailing Address - State:FL
Mailing Address - Zip Code:32533-4863
Mailing Address - Country:US
Mailing Address - Phone:850-324-3115
Mailing Address - Fax:850-416-4694
Practice Address - Street 1:5151 N 9TH AVE
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-8721
Practice Address - Country:US
Practice Address - Phone:850-416-6670
Practice Address - Fax:850-416-4694
Is Sole Proprietor?:No
Enumeration Date:2005-07-29
Last Update Date:2010-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9208055363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL305925100Medicaid
AL891009240Medicaid
FL305925100Medicaid
AL891009240Medicaid