Marrisa Shelley Kuba, RN, CRNP, MS

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

SP011636 Issued in PA

Practice address

2100 S 24TH St
Philadelphia, PA 19145-3222

Phone

(215) 952-8611

NPI assigned

Jun 13, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science, Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441584000000",
    "number": "1821292954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 S 24TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191453222",
            "telephone_number": "215-952-8611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 S 24TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191453222",
            "telephone_number": "215-952-8611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUBA",
        "first_name": "MARRISA",
        "middle_name": "SHELLEY",
        "credential": "RN, CRNP, MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-13",
        "last_updated": "2015-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "PA",
            "license": "SP011636",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN287003L",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Helen Ku, CRNP
• Shu Yu Ku, CRNP
• Henry Kuang, MD/PHD
• Shu-Zhen Kuang, DMD
• Ilana Kuba
• Kendra Kubala, PSY.D.
• Stephanie Ann Kubala, MD
• Rita Ann Kubicky, MD
• Jennifer Kubinski, OTR/L
• Kevin Kubinski, DPT

• Pediatric Nurse Practitioner in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Pediatric Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.