ETHAN BRENT CUNNINGHAM ATC NPI 1083013577

NPI Information

  • NPI: 1083013577
  • Provider Name: ETHAN BRENT CUNNINGHAM, ATC
  • Classification: Nurse Practitioner - 363L00000X
  • Entity Type: Individual
  • Address: 523 EDGEWORTHE DR SE
    ADA, MI
    ZIP 49301
  • Phone: (616) 745-8097

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NPI Details

Ethan Brent Cunningham, ATC is a nurse practitioner in Ada, MI. The provider is (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. Ethan Brent Cunningham, ATC NPI is 1083013577. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

523 EDGEWORTHE DR SE
ADA, MI
ZIP 49301-809
Phone: (616) 745-8097

The enumeration date for this NPI number is 8/20/2014 and was last updated on 9/5/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12255A2300XSpecialist/TechnologistAthletic Trainer2601000325MICHIGANNo
2363L00000XNurse Practitioner4704328016MICHIGANYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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