Individual
MICHELLE D HUBER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.PH., PHARMD
Contact information
Practice address
4300 HAMILTON BLVD, SIOUX CITY, IA 51104-1139
(712) 898-1996
(712) 233-1123
Mailing address
22620 GRENOBLE AVE, SIOUX CITY, IA 51108-8691
(712) 898-1996
Taxonomy
Speciality
Code
Description
License number
State
1835G0303X
Geriatric Pharmacist
Primary
18104
IA
1835P1200X
Pharmacotherapy Pharmacist
18104
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
119535
PHARMACIST LICENSE
MN
01
—
12625
PHARMACIST LICENSE
NE
01
—
18104
REGISTERD PHARMACIST LICENSE
IA
Enumeration date
04/11/2018
Last updated
04/11/2018
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