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General NPI Number Information
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NPI Number | 1851838130
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Entity Type | Individual
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Provider Name | MICHELLE LYNN KUBATKA CRNP
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Gender | Female
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Dates
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Enumeration Date | 01/25/2017
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Last Update Date | 01/25/2017
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Provider Practice Location Address
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Address Line | 3459 5TH AVE SELECT SPECIALTY HOSPITAL MONTEFIORE 8 SOUTH
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City | PITTSBURGH
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State | PA
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Zip | 15213-3236
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Country | US
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Telephone | 412-586-9819
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Fax |
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Provider Business Mailing Address
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Address Line | 102 ROBERTS AVE
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City | BURGETTSTOWN
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State | PA
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Zip | 15021-1131
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Country | US
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Telephone | 412-973-6190
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | SP016949
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License Number State | PA
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