Individual
ETHAN BRENT CUNNINGHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
523 EDGEWORTHE DR SE, ADA, MI 49301-7809
(616) 745-8097
Mailing address
523 EDGEWORTHE DR SE, ADA, MI 49301-7809
(616) 745-8097
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
4704328016
MI
Other
Enumeration date
08/20/2014
Last updated
05/13/2026
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