Provider Demographics
NPI:1073282489
Name:KUBIK, CAITLYN A (PA-C)
Entity Type:Individual
Prefix:
First Name:CAITLYN
Middle Name:A
Last Name:KUBIK
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:CAITLYN
Other - Middle Name:A
Other - Last Name:SKUODAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:PO BOX 24607
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-0607
Mailing Address - Country:US
Mailing Address - Phone:402-955-5400
Mailing Address - Fax:402-955-3674
Practice Address - Street 1:8200 DODGE ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-4113
Practice Address - Country:US
Practice Address - Phone:402-955-6300
Practice Address - Fax:402-955-6330
Is Sole Proprietor?:No
Enumeration Date:2021-09-09
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2648363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical