Provider Demographics
NPI:1154910875
Name:KUBIK, ALLISON JO (CNM)
Entity type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:JO
Last Name:KUBIK
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3474 PARIS RD
Mailing Address - Street 2:
Mailing Address - City:CENTER POINT
Mailing Address - State:IA
Mailing Address - Zip Code:52213-9796
Mailing Address - Country:US
Mailing Address - Phone:319-551-1077
Mailing Address - Fax:
Practice Address - Street 1:3474 PARIS RD
Practice Address - Street 2:
Practice Address - City:CENTER POINT
Practice Address - State:IA
Practice Address - Zip Code:52213-9796
Practice Address - Country:US
Practice Address - Phone:319-551-1077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-16
Last Update Date:2021-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAB156724367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife