Provider Demographics
NPI:1710413463
Name:GUBER-GERBER, KIMBERLEE RAE (NP)
Entity Type:Individual
Prefix:
First Name:KIMBERLEE
Middle Name:RAE
Last Name:GUBER-GERBER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10756 ASHLEY LN
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55129-6903
Mailing Address - Country:US
Mailing Address - Phone:210-392-9566
Mailing Address - Fax:612-873-1947
Practice Address - Street 1:701 PARK AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55415-1623
Practice Address - Country:US
Practice Address - Phone:612-873-7420
Practice Address - Fax:612-873-1947
Is Sole Proprietor?:No
Enumeration Date:2017-05-02
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCNP 5027363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care