| Doctor Name: | MS. PENNY L RUBESH |
| NPI Number: | 1013984491 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | MNR1163739 |
| Business Practice Address: | 1555 Northway Drive Suite 200 St Cloud, MN - 563034913 |
| Business Phone Number: | 3202403157 |
| Business Fax Number: | 3202403143 |
| Mailing Address: | 1555 Northway Drive, Suite 200 ST CLOUD |
| State: | MN |
| Postal Code: | 563034913 |
| Phone Number: | 3202403157 |
| Fax Number: | 3202403143 |
| NPI Enumeration Date: | 03/03/2006 |
| NPI Last Update Date: | 06/14/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | MNR1163739 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |