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General NPI Number Information
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NPI Number | 1396511051
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Entity Type | Individual
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Provider Name | JAIME ALANE HUBBELL PMHNP
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Gender | Female
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Dates
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Enumeration Date | 12/04/2023
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Last Update Date | 01/03/2024
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Provider Practice Location Address
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Address Line | 819 BLOOMINGTON RD
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City | CHAMPAIGN
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State | IL
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Zip | 61820-2101
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Country | US
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Telephone | 217-356-1558
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Fax |
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Provider Business Mailing Address
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Address Line | 1854 VISION CT
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City | MAHOMET
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State | IL
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Zip | 61853-3707
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Country | US
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Telephone | 225-235-3190
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | C-APN.0101525-C-NP
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 209029102
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License Number State | IL
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