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NPI Code Detail

MEDICARE: AMBER MARIE CUBBAGE NP

MEDICARE: AMBER MARIE CUBBAGE NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered NurseR174091MD
2363LF0000XFamily Nurse PractitionerR174091MD

General Provider Information

NPI Number : 1538453352
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMBER MARIE CUBBAGE NP
Provider Business Mailing Address
First Line : 1724 SUNNINGDALE LN
Second Line :
City : HANOVER
State : MD
Zip : 21076-1784
Country : US
Telephone Number : 301-452-7569
Fax Number :
Provider Business Practice Location Address
First Line : 2601 RIVA RD
Second Line :
City : ANNAPOLIS
State : MD
Zip : 21401-7304
Country : US
Telephone Number : 410-571-2090
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2011
Last Update Date : 06/09/2011

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