Active NPI
Kristel Ellen Kubis
- Case Management Registered Nurse
- Cloquet, MN
National Provider Identifier
1962995522
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Management Registered Nurse
- License
- RN1746664
- Practice address
- 807 Cloquet Ave
Cloquet, MN 55720 - Phone
- (218) 879-2035
- Fax
- (218) 879-3523
- NPI assigned
- Jun 8, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Management Registered Nurse | 163WC0400X | RN1746664 | MN | Primary |
Addresses
Primary practice location
807 Cloquet Ave
Cloquet, MN 55720
Mailing address
807 Cloquet Ave
Cloquet, MN 55720
Phone (218) 879-2035
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN1746664 | MN | MD | Case Management Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528416000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529107200000",
"number": "1962995522",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "807 CLOQUET AVE",
"city": "CLOQUET",
"state": "MN",
"postal_code": "55720",
"telephone_number": "218-879-2035",
"fax_number": "218-879-3523"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "807 CLOQUET AVE",
"city": "CLOQUET",
"state": "MN",
"postal_code": "55720",
"telephone_number": "218-879-2035",
"fax_number": "218-879-3523"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUBIS",
"first_name": "KRISTEL",
"middle_name": "ELLEN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-06-08",
"last_updated": "2018-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "163WC0400X",
"taxonomy_group": "",
"desc": "Registered Nurse, Case Management",
"state": "MN",
"license": "RN1746664",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cloquet, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.