Individual
MS. IDA MAY CUBITT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
790 FULLER NE, GRAND RAPIDS, MI 49503
(616) 855-5146
Mailing address
7034 VERDE VISTA DR NE, ROCKFORD, MI 49341-9622
(616) 874-1828
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704071273
MI
Other
Enumeration date
03/26/2015
Last updated
04/17/2015
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