Basic Information
| Provider Information | |||||||||
| NPI: | 1104911585 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HUBER | ||||||||
| FirstName: | JOY | ||||||||
| MiddleName: | |||||||||
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| Credential: | FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2600 WILSON STREET | ||||||||
| Address2: | |||||||||
| City: | MILES CITY | ||||||||
| State: | MT | ||||||||
| PostalCode: | 593015016 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4062332600 | ||||||||
| FaxNumber: | 4062332763 | ||||||||
| Practice Location | |||||||||
| Address1: | 2600 WILSON STREET | ||||||||
| Address2: | |||||||||
| City: | MILES CITY | ||||||||
| State: | MT | ||||||||
| PostalCode: | 593015016 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4062332600 | ||||||||
| FaxNumber: | 4062332763 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/03/2006 | ||||||||
| LastUpdateDate: | 07/09/2007 | ||||||||
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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 | 363L00000X | 14726 | MT | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
ID Information
| ID | Type | State | Issuer | Description | 0439673 | 05 | MT | MEDICAID | 14726 | 01 | MT | STATE LIC NUMBER | OTHER | 000374720 | 01 | MT | BCBS PROVIDER NUMBER | OTHER |