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Individual

ASHLEY L KUBIK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP-C

Contact information

Practice address
1235 E CHEROKEE ST, SPRINGFIELD, MO 65804-2203
(417) 820-6525
Mailing address
PO BOX 2580, SPRINGFIELD, MO 65801-2580
(417) 829-4620
(417) 829-4316

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
127680
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
139092
MO BLUE SHIELD
MO
05
159925758
AR
05
424658805
MO
01
82346
ARK BLUE SHIELD
AR
Enumeration date
02/15/2007
Last updated
07/14/2008
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