Healthcare Provider Details

I. General information

NPI: 1922425214
Provider Name (Legal Business Name): KATHRYN RUBEY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2014
Last Update Date: 07/21/2022
Certification Date: 09/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

999 N 92ND ST MEDICAL EDUCATION OFFICE, SUITE 730
MILWAUKEE WI
53226-4875
US

IV. Provider business mailing address

999 N 92ND ST MEDICAL EDUCATION OFFICE, SUITE 730
MILWAUKEE WI
53226-4875
US

V. Phone/Fax

Practice location:
  • Phone: 414-337-7030
  • Fax:
Mailing address:
  • Phone: 414-337-7030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberMT212509
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberMD470955
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: