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Contact Information

AMY M KUBAL
2450 RISNER DRIVE
ELLSWORTH AIR FORCE BASE HEALTH AND WELLNESS CENTER
ELLSWORTH AFB, SD57706
 Phone: 605-385-2349
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dietitian, Registered

133V00000X 71 Registered Dietitian or Nutrition Professional
Indicates primary specialty

NPI Profile & details for AMY M KUBAL · (Female)

NPI Number 1770736522
Status Active
Credentials
Entity Individual
Enumeration date 10/24/2008
Last updated 02/04/2009 - About 17 years ago
Sole proprietor 1 No
Identifiers
  • License # 00915063
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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