Provider Demographics
NPI:1023586468
Name:KUBOVIC, EMILY CLARE (FNP-C)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:CLARE
Last Name:KUBOVIC
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:CLARE
Other - Last Name:ROSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:10900 W 44TH AVE
Mailing Address - Street 2:UNIT 200
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-2742
Mailing Address - Country:US
Mailing Address - Phone:720-923-1239
Mailing Address - Fax:303-284-4082
Practice Address - Street 1:10900 W 44TH AVE UNIT 200
Practice Address - Street 2:
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-2742
Practice Address - Country:US
Practice Address - Phone:303-993-1330
Practice Address - Fax:303-957-5757
Is Sole Proprietor?:No
Enumeration Date:2018-11-03
Last Update Date:2020-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0993960363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily