Basic Information
Provider Information
NPI: 1851066385
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HUBER
FirstName: EMILY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: APRN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 550
Address2:  
City: VANCEBURG
State: KY
PostalCode: 411790550
CountryCode: US
TelephoneNumber: 6067963029
FaxNumber: 6067966221
Practice Location
Address1: 1551 AUGUSTA CHATHAM RD
Address2:  
City: AUGUSTA
State: KY
PostalCode: 410029224
CountryCode: US
TelephoneNumber: 6067562117
FaxNumber: 6067592135
Other Information
ProviderEnumerationDate: 08/16/2021
LastUpdateDate: 04/06/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/06/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XAPRN.CNP.0029515OHN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
363LF0000X3015756KYY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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