1922154723 NPI number — LESLIE K HUBBARD NP

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922154723 NPI number — LESLIE K HUBBARD NP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HUBBARD
Provider First Name:
LESLIE
Provider Middle Name:
K
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
NP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HUBBARD
Provider Other First Name:
LANI
Provider Other Middle Name:
K
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
APRN, GNP-BC
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1922154723
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/10/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
99-115 AIEA HEIGHTS DR STE 225
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AIEA
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96701-3974
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
803-280-8702
Provider Business Mailing Address Fax Number:
808-657-6564

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
99-115 AIEA HEIGHTS DR STE 225-575
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AIEA
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96701-3924
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
802-328-0870
Provider Business Practice Location Address Fax Number:
808-657-6564
Provider Enumeration Date:
01/25/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LG0600X , with the licence number:  APRN-565 , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0000248922 . This is a "HMSA BILLING NUMBER" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: 55769701 , issued by the state of ( HI ) . This identifiers is of the category "MEDICAID".




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