Healthcare Provider Details

I. General information

NPI: 1336232099
Provider Name (Legal Business Name): PATRICIA DUFFY CUNNINGHAM DNSC, APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

877 MADISON AVE STE 612
MEMPHIS TN
38163-0001
US

IV. Provider business mailing address

1668 FORREST AVE
MEMPHIS TN
38112-4927
US

V. Phone/Fax

Practice location:
  • Phone: 901-448-6103
  • Fax: 901-448-4121
Mailing address:
  • Phone: 901-272-0734
  • Fax: 901-448-4121

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN0000005925
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPN0000005925
License Number StateTN
# 3
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License NumberAPN0000005925
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: