Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ethan Brent Cunningham, FNP-C

Individual provider Primary Care Nurse Practitioner · NPI 1083013577

Ethan Brent Cunningham, FNP-C is a Nurse Practitioner in Ada, Michigan. Qualified in 2024, 2 years ago. Practices as a sole proprietor. Licensed in Michigan.

Years since qualifying
2
Licensed in
MI
In the registry since
2014
What do these letters mean?
FNP-C — Family Nurse Practitioner, Certified
A family nurse practitioner certified by the AANP.

See every abbreviation used in this directory →

Practice location Address checks out

523 Edgeworthe Dr SE
Ada, MI 49301-7809
Phone: (616) 745-8097
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Primary Care Nurse Practitioner (primary) Taxonomy 363LP2300X · Licence 4704328016 (MI)

Record details

NPI number1083013577
Entity typeIndividual (Type 1)
GenderMale
Credentials FNP-C
Sole proprietorYes
NPI enumeratedAugust 20, 2014
Last updated in NPPESMay 13, 2026
Certification dateMay 13, 2026
Mailing address523 Edgeworthe Dr Se, Ada, MI 49301-7809

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Accepts Medicare assignment Not indicated
Practice locations3 on file with Medicare