Provider Demographics
NPI:1821808775
Name:WUBBEN, GINA (RN)
Entity type:Individual
Prefix:
First Name:GINA
Middle Name:
Last Name:WUBBEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:GINA
Other - Middle Name:
Other - Last Name:LUDENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:6312 W 53RD ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57106-1920
Mailing Address - Country:US
Mailing Address - Phone:605-661-5771
Mailing Address - Fax:
Practice Address - Street 1:2501 W 22ND ST
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-1305
Practice Address - Country:US
Practice Address - Phone:605-336-3230
Practice Address - Fax:605-977-4406
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-13
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDR045506163WW0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WW0000XNursing Service ProvidersRegistered NurseWound Care