Provider Demographics
NPI:1679888598
Name:MCCUBBIN, FELECIA G (RN)
Entity Type:Individual
Prefix:MRS
First Name:FELECIA
Middle Name:G
Last Name:MCCUBBIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:FELECIA
Other - Middle Name:G
Other - Last Name:FLOYD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:3303 W ILLINOIS AVE
Mailing Address - Street 2:#22
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79703-6213
Mailing Address - Country:US
Mailing Address - Phone:432-681-7622
Mailing Address - Fax:
Practice Address - Street 1:3303 W ILLINOIS AVE
Practice Address - Street 2:#22
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79703-6213
Practice Address - Country:US
Practice Address - Phone:432-681-7622
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-16
Last Update Date:2010-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX245150163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health