Individual
MICAH NICOLE HUBBARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, FNP-C
Contact information
Practice address
133 S JEFFERSON ST, AVA, MO 65608-5530
(417) 812-8800
Mailing address
133 S JEFFERSON ST, AVA, MO 65608-5530
(417) 812-8800
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2018001741
MO
Other
Enumeration date
01/18/2018
Last updated
04/10/2021
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