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General NPI Number Information
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NPI Number | 1194342352
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Entity Type | Individual
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Provider Name | LAUREN CUNNINGHAM FNP
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Gender | Female
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Dates
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Enumeration Date | 07/02/2020
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Last Update Date | 07/02/2020
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Provider Practice Location Address
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Address Line | 930 W WILSON AVE
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City | MOORESVILLE
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State | NC
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Zip | 28117-8811
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Country | US
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Telephone | 704-663-7500
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Fax |
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Provider Business Mailing Address
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Address Line | 1190 CORRIHER GRAVEL RD
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City | CHINA GROVE
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State | NC
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Zip | 28023-8404
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 5013272
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License Number State | NC
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