Provider Demographics
NPI:1881180701
Name:CUBANO, NATASHA TEREZ
Entity Type:Individual
Prefix:
First Name:NATASHA
Middle Name:TEREZ
Last Name:CUBANO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6109 LOLLY LOOP
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76542-4688
Mailing Address - Country:US
Mailing Address - Phone:215-275-4561
Mailing Address - Fax:
Practice Address - Street 1:6109 LOLLY LOOP
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76542-4688
Practice Address - Country:US
Practice Address - Phone:215-275-4561
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-03
Last Update Date:2018-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN276410163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse