Provider Demographics
NPI:1740574433
Name:GUBLER, KATRINA ADELE (CNM)
Entity Type:Individual
Prefix:
First Name:KATRINA
Middle Name:ADELE
Last Name:GUBLER
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:515 S 300 E
Mailing Address - Street 2:SUITE 205
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84770-3979
Mailing Address - Country:US
Mailing Address - Phone:435-674-0999
Mailing Address - Fax:435-674-0960
Practice Address - Street 1:515 S 300 E
Practice Address - Street 2:SUITE 205
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84770-3900
Practice Address - Country:US
Practice Address - Phone:435-674-0999
Practice Address - Fax:435-674-0960
Is Sole Proprietor?:No
Enumeration Date:2011-05-31
Last Update Date:2011-05-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
UT288568-4402367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife