Healthcare Provider Details

I. General information

NPI: 1790748655
Provider Name (Legal Business Name): CATHY THERESE GUBERSKY R.N.,LIC.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1410 BANNER CIR
ERIE CO
80516-6953
US

IV. Provider business mailing address

1410 BANNER CIR
ERIE CO
80516-6953
US

V. Phone/Fax

Practice location:
  • Phone: 303-513-0801
  • Fax:
Mailing address:
  • Phone: 303-513-0801
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number992
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: