MEDICARE: MS. JEANNE HUBNER NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	F302119-1	NY

General Provider Information

NPI Number	:	1124141338
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JEANNE HUBNER NP

Provider Business Mailing Address
First Line	:	PO BOX 324
Second Line	:
City	:	SOMERS
State	:	NY
Zip	:	10589-0324
Country	:	US
Telephone Number	:	914-552-6413
Fax Number	:

Provider Business Practice Location Address
First Line	:	46 MOUNT EBO RD N
Second Line	:
City	:	BREWSTER
State	:	NY
Zip	:	10509-3600
Country	:	US
Telephone Number	:	845-278-3636
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/10/2007
Last Update Date	:	07/08/2007

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