Provider Demographics
NPI:1437486834
Name:HUBER, JUDITH LYNNE (LPN)
Entity Type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:LYNNE
Last Name:HUBER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:844 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:OH
Mailing Address - Zip Code:44001-2118
Mailing Address - Country:US
Mailing Address - Phone:440-714-5470
Mailing Address - Fax:
Practice Address - Street 1:844 S MAIN ST
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:OH
Practice Address - Zip Code:44001-2118
Practice Address - Country:US
Practice Address - Phone:440-714-5470
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-06
Last Update Date:2009-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN044837164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse