Provider Demographics
NPI:1073175261
Name:RUBLE, KRISTINE ANNE (CRNP)
Entity Type:Individual
Prefix:
First Name:KRISTINE
Middle Name:ANNE
Last Name:RUBLE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-733-6546
Mailing Address - Fax:717-733-6011
Practice Address - Street 1:446 N READING RD STE 301
Practice Address - Street 2:
Practice Address - City:EPHRATA
Practice Address - State:PA
Practice Address - Zip Code:17522
Practice Address - Country:US
Practice Address - Phone:717-733-6546
Practice Address - Fax:717-733-6011
Is Sole Proprietor?:No
Enumeration Date:2019-07-08
Last Update Date:2019-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP020454363LF0000X
PAMR5397458363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily