Provider Demographics
NPI:1447373691
Name:HUBEL, KRISTYN JOY (ATC)
Entity type:Individual
Prefix:MS
First Name:KRISTYN
Middle Name:JOY
Last Name:HUBEL
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 SHERMAN ST STE 299
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55102-2567
Mailing Address - Country:US
Mailing Address - Phone:651-291-9000
Mailing Address - Fax:
Practice Address - Street 1:360 SHERMAN ST STE 299
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102-2567
Practice Address - Country:US
Practice Address - Phone:651-291-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2010-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN0704025862255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer