Provider Demographics
NPI:1942621628
Name:KUBES, SHEILA (PA-C)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:
Last Name:KUBES
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:SHEILA
Other - Middle Name:
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:2208 S 17TH ST
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-7593
Mailing Address - Country:US
Mailing Address - Phone:910-763-3333
Mailing Address - Fax:910-763-3336
Practice Address - Street 1:2208 S 17TH ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401
Practice Address - Country:US
Practice Address - Phone:910-763-3333
Practice Address - Fax:910-763-3336
Is Sole Proprietor?:No
Enumeration Date:2013-12-23
Last Update Date:2019-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPA.0003845363AS0400X
NC0010-08971363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical