Healthcare Provider Details

I. General information

NPI: 1518235308
Provider Name (Legal Business Name): ANGELINA HUBERT RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/07/2011
Last Update Date: 04/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 DELBON AVE
TURLOCK CA
95382-2016
US

IV. Provider business mailing address

7111 FAIRWAY DR SUITE 450
PALM BEACH GARDENS FL
33418-4204
US

V. Phone/Fax

Practice location:
  • Phone: 559-259-2875
  • Fax:
Mailing address:
  • Phone: 561-799-3552
  • Fax: 865-291-3612

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN482313
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: