Kathleen Lynnette Kube, LPN

Individual provider Active NPI Licensed Practical Nurse · Plover, WI

NPI 1972180578 · NPPES record last updated Mar 28, 2021

Key facts

NPI
1972180578
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
324984-31 (WI)
Practice address
1520 Green Tree Dr
Plover, WI 54467-2300
Phone
(715) 295-4707
NPI assigned
Mar 28, 2021
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
324984-31WIMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 324984-31 WI Yes

Addresses

Primary practice location

1520 Green Tree Dr
Plover, WI 54467-2300

Mailing address

1520 Green Tree Dr
Plover, WI 54467-2300
Phone (715) 295-4707

Other providers in Plover, WI

All providers in Plover, WI · Licensed Practical Nurse in Wisconsin

Sources for this page

Verify at the official NPI Registry.