MEDICARE: VICKI A CUNNARD NP

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	363L00000X	Nurse Practitioner	SP006366B	PA

General Provider Information

NPI Number	:	1568423812
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICKI A CUNNARD NP

Provider Business Mailing Address
First Line	:	501 W OTTERMAN ST
Second Line	:	SUITE B
City	:	GREENSBURG
State	:	PA
Zip	:	15601-2126
Country	:	US
Telephone Number	:	724-850-6933
Fax Number	:	724-836-6825

Provider Business Practice Location Address
First Line	:	508 S CHURCH ST
Second Line	:
City	:	MT PLEASANT
State	:	PA
Zip	:	15666-1702
Country	:	US
Telephone Number	:	724-832-4626
Fax Number	:	724-836-6825

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

Provider Enumeration Date	:	03/28/2006
Last Update Date	:	02/14/2013

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