Healthcare Provider Details

I. General information

NPI: 1194541391
Provider Name (Legal Business Name): KYNSLEE CUMMINGS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/03/2024
Last Update Date: 12/03/2024
Certification Date: 12/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1525 LEIGHTON AVE STE B
ANNISTON AL
36207-3805
US

IV. Provider business mailing address

1525 LEIGHTON AVE STE B
ANNISTON AL
36207-3805
US

V. Phone/Fax

Practice location:
  • Phone: 256-343-4080
  • Fax: 256-937-7063
Mailing address:
  • Phone: 256-343-4080
  • Fax: 256-937-7063

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6618G
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: