NPI Code Detail JSON Logo

1649088709 NPI number — REBECCA KUBOTA NP

NPI Number: 1649088709
Health Care Provider/Practitioner: REBECCA KUBOTA NP

Information about “1649088709” NPI (REBECCA KUBOTA NP) exists in 1649088709 in HTML format HTML  |  1649088709 in plain Text format TXT  |  1649088709 in PDF (Portable Document Format) PDF  |  1649088709 in an XML format XML  formats.

NPI Number : 1649088709 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1649088709",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "KUBOTA",
    "FirstName": "REBECCA",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "NP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "2186 N MONTAGNA ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "WASHINGTON",
    "MailingAddressStateName": "UT",
    "MailingAddressPostalCode": "84780-3123",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "435-469-2156",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "42 S RIVER RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "ST GEORGE",
    "PracticeLocationAddressStateName": "UT",
    "PracticeLocationAddressPostalCode": "84790-2139",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "435-469-2156",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "12/20/2024",
    "LastUpdateDate": "12/20/2024",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "363LF0000X",
        "TaxonomyName": "Family Nurse Practitioner",
        "LicenseNumber": "10968170-4405",
        "LicenseNumberStateCode": "UT",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.