Provider Demographics
NPI:1184907743
Name:CUBETA, TINA M (APN, BC)
Entity type:Individual
Prefix:
First Name:TINA
Middle Name:M
Last Name:CUBETA
Suffix:
Gender:F
Credentials:APN, BC
Other - Prefix:
Other - First Name:TINA
Other - Middle Name:M
Other - Last Name:SITARAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:500 W 10TH ST
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19801-1422
Mailing Address - Country:US
Mailing Address - Phone:302-230-9154
Mailing Address - Fax:302-691-1100
Practice Address - Street 1:500 W 10TH ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19801-1422
Practice Address - Country:US
Practice Address - Phone:302-230-9154
Practice Address - Fax:302-691-1100
Is Sole Proprietor?:No
Enumeration Date:2011-09-21
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL8-0000106363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner