Healthcare Provider Details

I. General information

NPI: 1669863619
Provider Name (Legal Business Name): VERLEE CUNNINGHAM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/12/2015
Last Update Date: 02/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

867 W INGOMAR RD
PITTSBURGH PA
15237-4304
US

IV. Provider business mailing address

867 W INGOMAR RD
PITTSBURGH PA
15237-4304
US

V. Phone/Fax

Practice location:
  • Phone: 304-551-2640
  • Fax:
Mailing address:
  • Phone: 304-551-2640
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WW0101X
TaxonomyAmbulatory Women's Health Care Registered Nurse
License Number163WW0101X
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: