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NPI Code Detail

MEDICARE: KIMBERLY JEAN MCCUBLEY MS, GC

MEDICARE: KIMBERLY JEAN MCCUBLEY MS, GC
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
1170300000XGenetic Counselor (M.S.)

General Provider Information

NPI Number : 1356164255
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY JEAN MCCUBLEY MS, GC
Provider Business Mailing Address
First Line : 4441 DIPLOMACY DR STE 400
Second Line :
City : ANCHORAGE
State : AK
Zip : 99508-5910
Country : US
Telephone Number : 907-729-6851
Fax Number :
Provider Business Practice Location Address
First Line : 4441 DIPLOMACY DR STE 400
Second Line :
City : ANCHORAGE
State : AK
Zip : 99508-5910
Country : US
Telephone Number : 907-729-6851
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/07/2024
Last Update Date : 03/30/2026

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