Provider Demographics
NPI:1851025159
Name:HUEBNER, MEGAN COLLEEN (PMHNP)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:COLLEEN
Last Name:HUEBNER
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:COLLEEN-HIGGINS
Other - Last Name:STODDART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:101 RIVERFRONT BLVD STE 710
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34205-8812
Mailing Address - Country:US
Mailing Address - Phone:941-776-4000
Mailing Address - Fax:
Practice Address - Street 1:100 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45504-2687
Practice Address - Country:US
Practice Address - Phone:513-853-8520
Practice Address - Fax:513-442-7695
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-12
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN2022014276363LP0808X
FLAPRN11021129363LP0808X
KY4023659363LP0808X
VA0024190823363LP0808X
OHAPRN.CNP.0036988363LP0808X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health