Doctor Name: | MRS. MAURINE FREE HUBER |
NPI Number: | 1003271040 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | 2015042084 |
Business Practice Address: | 400 S Kingshighway Blvd Saint Louis, MO - 631101014 |
Business Phone Number: | 3143629123 |
Business Fax Number: | 3147473338 |
Mailing Address: | 660 S Euclid Ave, C B 8072 SAINT LOUIS |
State: | MO |
Postal Code: | 631101010 |
Phone Number: | 3143629123 |
Fax Number: | 3147473338 |
NPI Enumeration Date: | 12/17/2015 |
NPI Last Update Date: | 03/07/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 2015042084 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |