Provider Demographics
NPI:1891498754
Name:KUBIS, JOY MARIE (MSN, APRN, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:JOY
Middle Name:MARIE
Last Name:KUBIS
Suffix:
Gender:F
Credentials:MSN, APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 BITTERSWEET LN
Mailing Address - Street 2:
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56001-3105
Mailing Address - Country:US
Mailing Address - Phone:218-310-8272
Mailing Address - Fax:
Practice Address - Street 1:7525 MITCHELL RD STE 100
Practice Address - Street 2:
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55344-1900
Practice Address - Country:US
Practice Address - Phone:612-924-3807
Practice Address - Fax:952-224-2284
Is Sole Proprietor?:No
Enumeration Date:2023-03-22
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN9993363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health