Provider Demographics
NPI:1851838130
Name:KUBATKA, MICHELLE LYNN (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:LYNN
Last Name:KUBATKA
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MISS
Other - First Name:MICHELLE
Other - Middle Name:LYNN
Other - Last Name:BRUNO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:102 ROBERTS AVE
Mailing Address - Street 2:
Mailing Address - City:BURGETTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15021-1131
Mailing Address - Country:US
Mailing Address - Phone:412-973-6190
Mailing Address - Fax:
Practice Address - Street 1:3459 5TH AVE
Practice Address - Street 2:SELECT SPECIALTY HOSPITAL MONTEFIORE 8 SOUTH
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-3236
Practice Address - Country:US
Practice Address - Phone:412-586-9819
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-25
Last Update Date:2017-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP016949363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily