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NPI Code Detail

MEDICARE: MRS. CARLA A BUBONICS FNP-BC

MEDICARE: MRS. CARLA A BUBONICS FNP-BC
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
1363LF0000XFamily Nurse PractitionerAPRN11021071FL
2363LF0000XFamily Nurse PractitionerAPRN.CNP.020974OH

General Provider Information

NPI Number : 1275063851
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CARLA A BUBONICS FNP-BC
Provider Business Mailing Address
First Line : 6480 ROCKSIDE WOODS BLVD S STE 330
Second Line :
City : INDEPENDENCE
State : OH
Zip : 44131-2222
Country : US
Telephone Number : 855-490-9434
Fax Number :
Provider Business Practice Location Address
First Line : 6480 ROCKSIDE WOODS BLVD S STE 330
Second Line :
City : INDEPENDENCE
State : OH
Zip : 44131-2222
Country : US
Telephone Number : 855-490-9434
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2017
Last Update Date : 06/21/2023

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Directions to “ MRS. CARLA A BUBONICS FNP-BC” Practice Location

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