MEDICARE: KYLEE LUBIS

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	133V00000X	Registered Dietitian	86417815	CO

General Provider Information

NPI Number	:	1962247981
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KYLEE LUBIS

Provider Business Mailing Address
First Line	:	1935 S GRANT ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80210-4021
Country	:	US
Telephone Number	:	262-348-6545
Fax Number	:

Provider Business Practice Location Address
First Line	:	1935 S GRANT ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80210-4021
Country	:	US
Telephone Number	:	262-348-6545
Fax Number	:

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

Provider Enumeration Date	:	07/01/2024
Last Update Date	:	04/27/2026

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Directions to “ KYLEE LUBIS ” Practice Location

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