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Individual

DAULTON HUBER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
500 SHREWSBURY CT, JEFFERSON, LA 70121-2627
(337) 309-4898
Mailing address
500 SHREWSBURY CT, JEFFERSON, LA 70121-2627
(337) 309-4898

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN150658
LA
367500000X
Certified Registered Nurse Anesthetist
Primary
220292
LA

Other

Enumeration date
04/13/2020
Last updated
10/26/2021
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