Provider Demographics
NPI:1598062499
Name:HUBNER, BRANDI KAY (RN)
Entity Type:Individual
Prefix:
First Name:BRANDI
Middle Name:KAY
Last Name:HUBNER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 MAIN ST W
Mailing Address - Street 2:
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56001-6234
Mailing Address - Country:US
Mailing Address - Phone:507-469-2276
Mailing Address - Fax:
Practice Address - Street 1:227 E MAIN ST
Practice Address - Street 2:SUITE 200
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-7732
Practice Address - Country:US
Practice Address - Phone:507-345-8591
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-12
Last Update Date:2011-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR 170817-8163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse