Provider Demographics
NPI:1538208194
Name:HUBER, LYNNE MARIE (RN,BSN,CNOR,RNFA)
Entity type:Individual
Prefix:
First Name:LYNNE
Middle Name:MARIE
Last Name:HUBER
Suffix:
Gender:F
Credentials:RN,BSN,CNOR,RNFA
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 2710
Mailing Address - Street 2:
Mailing Address - City:ROWLETT
Mailing Address - State:TX
Mailing Address - Zip Code:75030-2710
Mailing Address - Country:US
Mailing Address - Phone:214-607-0471
Mailing Address - Fax:214-607-0491
Practice Address - Street 1:3906 MELCER DR
Practice Address - Street 2:SUITE 302
Practice Address - City:ROWLETT
Practice Address - State:TX
Practice Address - Zip Code:75088-7728
Practice Address - Country:US
Practice Address - Phone:214-607-0471
Practice Address - Fax:214-607-0491
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX235458163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant