Healthcare Provider Details

I. General information

NPI: 1669753448
Provider Name (Legal Business Name): JESSICA MARIE HUBER ANP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. JESSICA MARIE BARNETTE

II. Dates (important events)

Enumeration Date: 09/07/2011
Last Update Date: 09/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

DUMC 3704 DEPARTMENT OF SURGERY
DURHAM NC
27710
US

IV. Provider business mailing address

2455 GOLDEN FOREST DR
FRANKLINTON NC
27525-7113
US

V. Phone/Fax

Practice location:
  • Phone: 919-681-2425
  • Fax: 919-681-7163
Mailing address:
  • Phone: 919-632-0695
  • Fax: 919-681-6690

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberA0711135
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: