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NPI Code Detail

MEDICARE: SHANA LYNN KUBENA

MEDICARE: SHANA LYNN KUBENA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training ProgramCO

General Provider Information

NPI Number : 1114878972
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANA LYNN KUBENA
Provider Business Mailing Address
First Line : 1401 ANITA ST
Second Line :
City : PUEBLO
State : CO
Zip : 81001-2122
Country : US
Telephone Number : 719-225-6510
Fax Number :
Provider Business Practice Location Address
First Line : 1401 ANITA ST
Second Line :
City : PUEBLO
State : CO
Zip : 81001-2122
Country : US
Telephone Number : 719-225-6510
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/06/2026
Last Update Date : 02/06/2026

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Directions to “ SHANA LYNN KUBENA ” Practice Location

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