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General NPI Number Information
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NPI Number | 1710154596
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Entity Type | Individual
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Provider Name | SANDRA K MCCUBBREY FNP
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Gender | Female
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Dates
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Enumeration Date | 05/12/2008
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Last Update Date | 05/12/2008
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Provider Practice Location Address
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Address Line | 211 LONG RAPIDS RD
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City | ALPENA
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State | MI
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Zip | 49707-1315
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Country | US
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Telephone | 989-354-2142
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Fax | 989-354-6166
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Provider Business Mailing Address
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Address Line | 211 LONG RAPIDS RD
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City | ALPENA
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State | MI
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Zip | 49707-1315
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Country | US
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Telephone | 989-354-2142
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Fax | 989-354-6166
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 4704123876
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License Number State | MI
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