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Individual
KIRSTEN ELLEN BUBB
Active
Individual
KIRSTEN ELLEN BUBB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN574721
PA
363L00000X
Nurse Practitioner
Primary
SP013148
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103171980-0002
—
PA
01
—
6Z2801
MEDICARE PTAN
PA
Enumeration date
09/13/2013
Last updated
11/01/2024
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