Provider Demographics
NPI:1699412346
Name:HUEBNER, KATIE LYNETTE (RN)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:LYNETTE
Last Name:HUEBNER
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 1:6935 MONCLOVA RD
Mailing Address - Street 2:
Mailing Address - City:MAUMEE
Mailing Address - State:OH
Mailing Address - Zip Code:43537-9353
Mailing Address - Country:US
Mailing Address - Phone:419-866-3030
Mailing Address - Fax:419-866-3031
Practice Address - Street 1:6935 MONCLOVA RD
Practice Address - Street 2:
Practice Address - City:MAUMEE
Practice Address - State:OH
Practice Address - Zip Code:43537-9353
Practice Address - Country:US
Practice Address - Phone:419-866-3030
Practice Address - Fax:419-866-3031
Is Sole Proprietor?:No
Enumeration Date:2022-05-15
Last Update Date:2022-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH364244163WI0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WI0600XNursing Service ProvidersRegistered NurseInfection Control