Provider Demographics
NPI:1790910107
Name:HUEBNER, MICHELLE LINN (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:LINN
Last Name:HUEBNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 476 BOX 836
Mailing Address - Street 2:
Mailing Address - City:FPO
Mailing Address - State:AP
Mailing Address - Zip Code:96322-0009
Mailing Address - Country:US
Mailing Address - Phone:0806-664-8107
Mailing Address - Fax:
Practice Address - Street 1:USS TORTUGA (LSD-46)
Practice Address - Street 2:
Practice Address - City:FPO
Practice Address - State:AP
Practice Address - Zip Code:96679
Practice Address - Country:US
Practice Address - Phone:0806-664-8107
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-29
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01067894A207Q00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program