Healthcare Provider Details

I. General information

NPI: 1063340818
Provider Name (Legal Business Name): MONICA M PETERSON CUNNINGHAM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1424 SHIPPEN LN SE
WASHINGTON DC
20020-2904
US

IV. Provider business mailing address

1308 OATES ST
CAPITOL HEIGHTS MD
20743-1249
US

V. Phone/Fax

Practice location:
  • Phone: 202-867-9235
  • Fax:
Mailing address:
  • Phone: 202-230-1120
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: