Healthcare Provider Details

I. General information

NPI: 1407629975
Provider Name (Legal Business Name): PAUL CUMMINGS RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2023
Last Update Date: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1905 E ST SE
WASHINGTON DC
20003-2593
US

IV. Provider business mailing address

11275 BURBERRY ST
WHITE PLAINS MD
20695-3188
US

V. Phone/Fax

Practice location:
  • Phone: 202-673-9319
  • Fax:
Mailing address:
  • Phone: 347-773-9615
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR236391
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN1055358
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: