Provider Demographics
NPI:1518193085
Name:HUBERT, HALEY JEANNE (TLMLP)
Entity Type:Individual
Prefix:
First Name:HALEY
Middle Name:JEANNE
Last Name:HUBERT
Suffix:
Gender:F
Credentials:TLMLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2224
Mailing Address - Street 2:
Mailing Address - City:EMPORIA
Mailing Address - State:KS
Mailing Address - Zip Code:66801-6220
Mailing Address - Country:US
Mailing Address - Phone:620-343-7746
Mailing Address - Fax:620-342-0745
Practice Address - Street 1:618 COMMERCIAL ST
Practice Address - Street 2:
Practice Address - City:EMPORIA
Practice Address - State:KS
Practice Address - Zip Code:66801-3969
Practice Address - Country:US
Practice Address - Phone:620-343-7746
Practice Address - Fax:620-342-0745
Is Sole Proprietor?:No
Enumeration Date:2009-06-10
Last Update Date:2009-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program