Healthcare Provider Details

I. General information

NPI: 1942912829
Provider Name (Legal Business Name): EMILY PAIGE CUMMINGS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/22/2022
Last Update Date: 12/22/2022
Certification Date: 12/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

298 TRICORN RD
DANVILLE WV
25053-7148
US

IV. Provider business mailing address

4710 MIDWAY RD
YAWKEY WV
25573-9730
US

V. Phone/Fax

Practice location:
  • Phone: 304-369-1385
  • Fax:
Mailing address:
  • Phone: 304-951-4649
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number39739
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: