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General NPI Number Information
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NPI Number | 1972263200
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Entity Type | Individual
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Provider Name | BAILEY M HUEBNER
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Gender | Female
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Dates
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Enumeration Date | 12/28/2021
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Last Update Date | 01/24/2025
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Provider Practice Location Address
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Address Line | 3437 CAROLINE ST
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City | SAINT LOUIS
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State | MO
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Zip | 63104-1111
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Country | US
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Telephone | 314-977-2570
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Fax |
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Provider Business Mailing Address
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Address Line | 6055 STATE ROUTE 3
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City | WATERLOO
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State | IL
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Zip | 62298-3011
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Country | US
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Telephone | 618-340-0390
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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