Healthcare Provider Details

I. General information

NPI: 1326815291
Provider Name (Legal Business Name): EMILY CAROLINE CUNNINGHAM APRN , FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2023
Last Update Date: 02/07/2024
Certification Date: 02/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2270 ASHLEY CROSSING DR STE 165
CHARLESTON SC
29414-5865
US

IV. Provider business mailing address

2270 ASHLEY CROSSING DR STE 165
CHARLESTON SC
29414-5865
US

V. Phone/Fax

Practice location:
  • Phone: 843-936-4455
  • Fax:
Mailing address:
  • Phone: 843-936-4455
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberAPN.28187
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: