Provider Demographics
NPI:1346533718
Name:HRUBY, JOYCE KATHLEEN (LPN-C)
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:KATHLEEN
Last Name:HRUBY
Suffix:
Gender:F
Credentials:LPN-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81031 467TH AVE
Mailing Address - Street 2:
Mailing Address - City:ORD
Mailing Address - State:NE
Mailing Address - Zip Code:68862-5333
Mailing Address - Country:US
Mailing Address - Phone:308-728-3183
Mailing Address - Fax:308-728-5015
Practice Address - Street 1:81031 467TH AVE
Practice Address - Street 2:
Practice Address - City:ORD
Practice Address - State:NE
Practice Address - Zip Code:68862-5333
Practice Address - Country:US
Practice Address - Phone:308-728-3183
Practice Address - Fax:308-728-5015
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-18
Last Update Date:2011-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE7148164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE$$$$$$$$$02Medicaid