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Individual

KATIE RUBLE KIM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT

Contact information

Practice address
301 E HILLCREST AVE, INDIANOLA, IA 50125-9027
(515) 961-3700
Mailing address
301 E HILLCREST AVE, INDIANOLA, IA 50125-9027
(515) 961-3700

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
002402
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P01329951
RR MEDICARE
IA
Enumeration date
07/10/2013
Last updated
08/19/2014
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