Healthcare Provider Details

I. General information

NPI: 1710803242
Provider Name (Legal Business Name): NATALIE CUNNINGHAM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: NATALIE BARTH

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 CROSS CREEK RD
AVELLA PA
15312-2746
US

IV. Provider business mailing address

119 CROSS CREEK RD
AVELLA PA
15312-2746
US

V. Phone/Fax

Practice location:
  • Phone: 724-825-2078
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP036320
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: