Provider Demographics
NPI:1013716851
Name:KUBUTA, MERCY W
Entity type:Individual
Prefix:
First Name:MERCY
Middle Name:W
Last Name:KUBUTA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 WOODS BLVD APT 611
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68502-5838
Mailing Address - Country:US
Mailing Address - Phone:531-218-7980
Mailing Address - Fax:
Practice Address - Street 1:2800 WOODS BLVD APT 611
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68502-5838
Practice Address - Country:US
Practice Address - Phone:531-218-7980
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-12
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide