Individual
LUKE HUBBARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1701 LACEY ST, CAPE GIRARDEAU, MO 63701-5230
(573) 651-5562
(573) 651-5868
Mailing address
2059 DERWIN CIR, JACKSON, MO 63755-8551
(573) 979-1491
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2010003635
MO
367500000X
Certified Registered Nurse Anesthetist
Primary
110038
MO
Other
Enumeration date
07/26/2015
Last updated
02/28/2016
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