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General NPI Number Information
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NPI Number | 1467931428
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Entity Type | Individual
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Provider Name | DANA KUBSKA FNP
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Gender | Female
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Dates
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Enumeration Date | 08/10/2018
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Last Update Date | 08/10/2018
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Provider Practice Location Address
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Address Line | 29339 EUCLID AVE STE 206
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City | WICKLIFFE
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State | OH
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Zip | 44092-1985
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Country | US
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Telephone | 216-261-6398
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Fax | 440-525-5564
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Provider Business Mailing Address
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Address Line | 29339 EUCLID AVE
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City | WICKLIFFE
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State | OH
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Zip | 44092-1986
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Country | US
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Telephone | 216-261-6398
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | F03180070
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License Number State | OH
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