MEDICARE: MRS. JANET L KUBAS NP

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	363LA2100X	Acute Care Nurse Practitioner	2518	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2518	OTHER	SC	SC LICENSE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1679575559
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JANET L KUBAS NP

Provider Business Mailing Address
First Line	:	330 SEVEN SPRINGS WAY
Second Line	:
City	:	BRENTWOOD
State	:	TN
Zip	:	37027-5098
Country	:	US
Telephone Number	:	615-920-7878
Fax Number	:	615-920-8775

Provider Business Practice Location Address
First Line	:	114 GATEWAY CORPORATE BLVD STE 420
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29203-9785
Country	:	US
Telephone Number	:	803-365-8650
Fax Number	:	803-365-8659

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

Provider Enumeration Date	:	08/11/2005
Last Update Date	:	02/22/2019

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