Healthcare Provider Details

I. General information

NPI: 1417809096
Provider Name (Legal Business Name): RHIANNON LEE CUMMINGS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2026
Last Update Date: 02/13/2026
Certification Date: 02/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4808 NORTHLAND DR
MORLEY MI
49336-9522
US

IV. Provider business mailing address

6058 YOUNGMAN RD
GREENVILLE MI
48838-8166
US

V. Phone/Fax

Practice location:
  • Phone: 231-856-7684
  • Fax:
Mailing address:
  • Phone: 616-337-7042
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: