Provider Demographics
NPI:1053544981
Name:HULBERT, DANA KAYE (ARNP)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:KAYE
Last Name:HULBERT
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:DANA
Other - Middle Name:KAYE
Other - Last Name:ALEXANDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 2309
Mailing Address - Street 2:SECTION 2
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73502-2309
Mailing Address - Country:US
Mailing Address - Phone:580-355-5242
Mailing Address - Fax:580-355-5245
Practice Address - Street 1:3811 W GORE BLVD
Practice Address - Street 2:STE 6
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-6328
Practice Address - Country:US
Practice Address - Phone:580-355-5242
Practice Address - Fax:580-355-5245
Is Sole Proprietor?:No
Enumeration Date:2009-08-26
Last Update Date:2014-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK78823363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics