Doctor Name: | AMY MARIE KUBAL |
NPI Number: | 1770736522 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 00915063 |
Business Practice Address: | 2450 Risner Drive Ellsworth Air Force Base Health And Wellness Center Ellsworth Afb, SD - 57706 |
Business Phone Number: | 6053852349 |
Business Fax Number: | |
Mailing Address: | 4521 Homestead St, #303 RAPID CITY |
State: | SD |
Postal Code: | 577030223 |
Phone Number: | 9704201642 |
Fax Number: | |
NPI Enumeration Date: | 10/24/2008 |
NPI Last Update Date: | 02/04/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | 00915063 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Dietary & Nutritional Service Providers |
Taxonomy Classification: | Dietitian, Registered |
Taxonomy Specialization: | |
Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |