| NPI | 1669980603 |
|---|---|
| Former Name | COURTNEY BLAINE KUBICEK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP135347) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP135347) |
| Enumeration Date | 2018-01-11 |
| Last Update Date | 2024-04-17 |