Provider Demographics
NPI:1982797619
Name:KUBES, LAURIE FRANCES (NP)
Entity Type:Individual
Prefix:MRS
First Name:LAURIE
Middle Name:FRANCES
Last Name:KUBES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2970 179TH ST EAST
Mailing Address - Street 2:
Mailing Address - City:PRIOR LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55372
Mailing Address - Country:US
Mailing Address - Phone:952-440-9839
Mailing Address - Fax:
Practice Address - Street 1:ONE VETERANS DRIVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55417
Practice Address - Country:US
Practice Address - Phone:612-467-1125
Practice Address - Fax:612-467-5222
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN0372385363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner