Provider Demographics
NPI:1235418450
Name:HUBER, JOANNA
Entity Type:Individual
Prefix:MRS
First Name:JOANNA
Middle Name:
Last Name:HUBER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:830 BARKSDALE DR
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37918-9724
Mailing Address - Country:US
Mailing Address - Phone:865-806-9994
Mailing Address - Fax:480-393-5308
Practice Address - Street 1:830 BARKSDALE DR
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37918-9724
Practice Address - Country:US
Practice Address - Phone:865-806-9994
Practice Address - Fax:480-393-5308
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-04
Last Update Date:2011-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0239339332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies