Healthcare Provider Details

I. General information

NPI: 1801332499
Provider Name (Legal Business Name): CATHERINE RAE HUBLER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CATHERINE RAE HUBER PA-C

II. Dates (important events)

Enumeration Date: 01/06/2017
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3545 HIGHWAY 61 N
VADNAIS HEIGHTS MN
55110-5223
US

IV. Provider business mailing address

3500 AMERICAN BLVD W STE 300
BLOOMINGTON MN
55431-4442
US

V. Phone/Fax

Practice location:
  • Phone: 651-439-8807
  • Fax: 651-439-0232
Mailing address:
  • Phone: 952-512-5600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number12358
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: