Healthcare Provider Details

I. General information

NPI: 1750350229
Provider Name (Legal Business Name): BARBARA ANN CUNNINGHAM BSN, MS,APRN,BC, CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/16/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 MIRANDA AVE
PALO ALTO CA
94304-1207
US

IV. Provider business mailing address

939 ROSE BLOSSOM DR
CUPERTINO CA
95014-4215
US

V. Phone/Fax

Practice location:
  • Phone: 650-493-5000
  • Fax:
Mailing address:
  • Phone: 408-257-1307
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SG0600X
TaxonomyGerontology Clinical Nurse Specialist
License Number425702
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: