MEDICARE: REBECCA KUBITZA

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
1	363LF0000X	Family Nurse Practitioner	18409	OH

General Provider Information

NPI Number	:	1225493877
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA KUBITZA

Provider Business Mailing Address
First Line	:	9200 WORTHINGTON ROAD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43082
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9200 WORTHINGTON RD
Second Line	:
City	:	WESTERVILLE
State	:	OH
Zip	:	43082-8823
Country	:	US
Telephone Number	:	614-890-6852
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/28/2015
Last Update Date	:	12/28/2015

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Directions to “ REBECCA KUBITZA ” Practice Location

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