MEDICARE: MISS EMILY CAROLINE CUNNINGHAM APRN , FNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	APN.28187	SC

General Provider Information

NPI Number	:	1326815291
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS EMILY CAROLINE CUNNINGHAM APRN , FNP-BC

Provider Business Mailing Address
First Line	:	2270 ASHLEY CROSSING DR STE 165
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29414-5865
Country	:	US
Telephone Number	:	843-936-4455
Fax Number	:

Provider Business Practice Location Address
First Line	:	2270 ASHLEY CROSSING DR STE 165
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29414-5865
Country	:	US
Telephone Number	:	843-936-4455
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/11/2023
Last Update Date	:	02/07/2024

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