Provider Demographics
NPI:1023325578
Name:HUBBARD, STEPHANIE MICHELLE (PHARM D, RPH)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:MICHELLE
Last Name:HUBBARD
Suffix:
Gender:F
Credentials:PHARM D, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2006 HWY 35
Mailing Address - Street 2:
Mailing Address - City:SPRING LAKE
Mailing Address - State:NJ
Mailing Address - Zip Code:07762-2543
Mailing Address - Country:US
Mailing Address - Phone:732-282-0719
Mailing Address - Fax:
Practice Address - Street 1:2006 HWY 35
Practice Address - Street 2:
Practice Address - City:SPRING LAKE
Practice Address - State:NJ
Practice Address - Zip Code:07762-2543
Practice Address - Country:US
Practice Address - Phone:732-282-0719
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-04
Last Update Date:2010-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03367700183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist