Provider Demographics
NPI:1730681917
Name:HUEBNER, CHERYL (CSAC)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:HUEBNER
Suffix:
Gender:F
Credentials:CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16192 N MEADOWLARK LN
Mailing Address - Street 2:
Mailing Address - City:HULBERT
Mailing Address - State:OK
Mailing Address - Zip Code:74441-2108
Mailing Address - Country:US
Mailing Address - Phone:707-208-5146
Mailing Address - Fax:
Practice Address - Street 1:16192 N MEADOWLARK LN
Practice Address - Street 2:
Practice Address - City:HULBERT
Practice Address - State:OK
Practice Address - Zip Code:74441-2108
Practice Address - Country:US
Practice Address - Phone:707-208-5146
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-05
Last Update Date:2018-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist