Provider Demographics
NPI:1013349703
Name:KUBASEK, ROBIN LEE (CRNA)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:LEE
Last Name:KUBASEK
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 713749
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45271-3749
Mailing Address - Country:US
Mailing Address - Phone:614-761-1255
Mailing Address - Fax:614-761-0849
Practice Address - Street 1:6520 W CAMPUS OVAL
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:OH
Practice Address - Zip Code:43054-8726
Practice Address - Country:US
Practice Address - Phone:614-413-2233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-05
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.14935-NA367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered