Healthcare Provider Details

I. General information

NPI: 1902305352
Provider Name (Legal Business Name): MEGHAN CATHLENE CUMMINGS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/12/2018
Last Update Date: 02/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1105 SUNSET AVE
MANHATTAN KS
66502-3761
US

IV. Provider business mailing address

1105 SUNSET AVE
MANHATTAN KS
66502-3761
US

V. Phone/Fax

Practice location:
  • Phone: 785-532-6544
  • Fax: 785-532-3425
Mailing address:
  • Phone: 620-382-4470
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number53-78018-061
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: