Basic Information
| Provider Information | |||||||||
| NPI: | 1356527584 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HUBBARD | ||||||||
| FirstName: | DANA | ||||||||
| MiddleName: | MAY | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4102 PINION DR | ||||||||
| Address2: | 10TH MDG | ||||||||
| City: | USAF ACADEMY | ||||||||
| State: | CO | ||||||||
| PostalCode: | 808402502 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7193335042 | ||||||||
| FaxNumber: | 7193335868 | ||||||||
| Practice Location | |||||||||
| Address1: | 2446 RESEARCH PKWY STE 200 | ||||||||
| Address2: | |||||||||
| City: | COLORADO SPRINGS | ||||||||
| State: | CO | ||||||||
| PostalCode: | 809201087 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7196231050 | ||||||||
| FaxNumber: | 7196231051 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/17/2008 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363AS0400X | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Surgical | 363AS0400X | PA.0004039 | CO | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Surgical |
No ID Information.