Healthcare Provider Details

I. General information

NPI: 1114840790
Provider Name (Legal Business Name): BELINDA M KUBRI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11871 74TH ST NE
OTSEGO MN
55301-4721
US

IV. Provider business mailing address

11871 74TH ST NE
OTSEGO MN
55301-4721
US

V. Phone/Fax

Practice location:
  • Phone: 612-594-1169
  • Fax: 417-805-3764
Mailing address:
  • Phone: 612-594-1169
  • Fax: 417-805-3764

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number2480755
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: