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NPI Code Detail

MEDICARE: AUDREY ANNE HUBLER FNP

MEDICARE: AUDREY ANNE HUBLER FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerA188081IA
2363LF0000XFamily Nurse Practitioner2019010401MO
3363LF0000XFamily Nurse Practitioner18059-33WI
4363LF0000XFamily Nurse Practitioner14033MN
5363LF0000XFamily Nurse Practitioner209.035329IL
6363LF0000XFamily Nurse Practitioner0040833OH

General Provider Information

NPI Number : 1831754720
Entity Type Code : Individual
Provider Name (Legal Business Name) : AUDREY ANNE HUBLER FNP
Provider Business Mailing Address
First Line : 109 N BROADWAY ST
Second Line :
City : SOUTH WEST CITY
State : MO
Zip : 64863-9417
Country : US
Telephone Number : 417-762-3287
Fax Number : 417-762-3255
Provider Business Practice Location Address
First Line : 109 N BROADWAY ST
Second Line :
City : SOUTH WEST CITY
State : MO
Zip : 64863-9417
Country : US
Telephone Number : 417-762-3287
Fax Number : 417-762-3255
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/06/2019
Last Update Date : 04/20/2026

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