Provider Demographics
NPI:1194589135
Name:RUBINO, GENNA CHRISTINE (FNP-C, MSN)
Entity type:Individual
Prefix:
First Name:GENNA
Middle Name:CHRISTINE
Last Name:RUBINO
Suffix:
Gender:F
Credentials:FNP-C, MSN
Other - Prefix:MISS
Other - First Name:GENNA
Other - Middle Name:CHRISTINE
Other - Last Name:RUBINO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2101 OAKHEART RD
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29579-1256
Mailing Address - Country:US
Mailing Address - Phone:303-910-2045
Mailing Address - Fax:
Practice Address - Street 1:809 82ND PKWY
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29572-4607
Practice Address - Country:US
Practice Address - Phone:843-692-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-09
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCAPN.28361363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily