Provider Demographics
NPI:1952659781
Name:KOBYLANSKI, LINDA K
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:K
Last Name:KOBYLANSKI
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 1:3701 E BROADWAY AVE
Mailing Address - Street 2:
Mailing Address - City:APACHE JUNCTION
Mailing Address - State:AZ
Mailing Address - Zip Code:85119-9301
Mailing Address - Country:US
Mailing Address - Phone:480-677-7513
Mailing Address - Fax:
Practice Address - Street 1:3701 E BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:APACHE JUNCTION
Practice Address - State:AZ
Practice Address - Zip Code:85119-9301
Practice Address - Country:US
Practice Address - Phone:480-677-7513
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-28
Last Update Date:2012-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program