Basic Information
| Provider Information | |||||||||
| NPI: | 1497793343 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GUBBELS | ||||||||
| FirstName: | CINDY | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2000 Q ST | ||||||||
| Address2: | STE 500 | ||||||||
| City: | LINCOLN | ||||||||
| State: | NE | ||||||||
| PostalCode: | 685033610 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4024210896 | ||||||||
| FaxNumber: | 4024210946 | ||||||||
| Practice Location | |||||||||
| Address1: | 3237 S 16TH ST | ||||||||
| Address2: | |||||||||
| City: | MILWAUKEE | ||||||||
| State: | WI | ||||||||
| PostalCode: | 532154526 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4145278728 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/03/2006 | ||||||||
| LastUpdateDate: | 02/19/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 38699-020 | WI | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207PE0004X | 23845 | NE | Y | Allopathic & Osteopathic Physicians | Emergency Medicine | Emergency Medical Services |
ID Information
| ID | Type | State | Issuer | Description | 204590400 | 05 | MS | MEDICAID | 200405660A | 05 | KS | MEDICAID | 0745190 | 05 | IA | MEDICAID | 251758 | 01 | MIDLANDS CHOICE | OTHER | 3902309 | 01 | UHC | OTHER | 03128 | 01 | BCBS | OTHER | 32333900 | 05 | WI | MEDICAID |