Provider Demographics
NPI:1467931428
Name:KUBSKA, DANA (FNP)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:KUBSKA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29339 EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:WICKLIFFE
Mailing Address - State:OH
Mailing Address - Zip Code:44092-1986
Mailing Address - Country:US
Mailing Address - Phone:216-261-6398
Mailing Address - Fax:
Practice Address - Street 1:29339 EUCLID AVE STE 206
Practice Address - Street 2:
Practice Address - City:WICKLIFFE
Practice Address - State:OH
Practice Address - Zip Code:44092-1985
Practice Address - Country:US
Practice Address - Phone:216-261-6398
Practice Address - Fax:440-525-5564
Is Sole Proprietor?:No
Enumeration Date:2018-08-10
Last Update Date:2018-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHF03180070207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine