Kubly, Pamela L

Kubly, Pamela L is an individual health care provider with primary practice located at 4112 Outlook Blvd Suite 255, Pueblo CO 81008-1667. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Kubly, Pamela L can be contacted via phone (719) 253-7640.

Contact Information

Primary practice address
4112 Outlook Blvd Suite 255 Pueblo CO 81008-1667
Phone: (719) 253-7640
Fax: (719) 253-7644
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 59676 Colorado

Profile Details

NPI number 1053350496
LBN Legal business name Kubly, Pamela L
Credentials Certified Pediatric Nurse Practitioner (CPNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 4th, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053350496 NPPES
Colorado MEDICAID 07596760

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