Provider Demographics
NPI:1093307696
Name:KUBIK, EMMA (NNP)
Entity Type:Individual
Prefix:
First Name:EMMA
Middle Name:
Last Name:KUBIK
Suffix:
Gender:F
Credentials:NNP
Other - Prefix:
Other - First Name:EMMA
Other - Middle Name:
Other - Last Name:KILLION
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NNP
Mailing Address - Street 1:4745 OGLETOWN STANTON RD STE 217
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-2074
Mailing Address - Country:US
Mailing Address - Phone:302-733-2410
Mailing Address - Fax:302-733-2602
Practice Address - Street 1:4745 OGLETOWN STANTON RD STE 217
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2074
Practice Address - Country:US
Practice Address - Phone:302-733-2410
Practice Address - Fax:302-733-2602
Is Sole Proprietor?:No
Enumeration Date:2021-02-05
Last Update Date:2023-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0054031163W00000X
DELM-0010179363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal
No163W00000XNursing Service ProvidersRegistered Nurse