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General NPI Number Information
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NPI Number | 1205206091
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Entity Type | Individual
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Provider Name | BRANDON MILES CUNNINGHAM FNP
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Gender | Male
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Dates
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Enumeration Date | 10/06/2015
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Last Update Date | 09/24/2021
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Provider Practice Location Address
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Address Line | 861 MARTIN LUTHER KING JR WAY STE 101
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City | HARRISONBURG
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State | VA
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Zip | 22801-3278
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Country | US
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Telephone | 540-290-1540
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Fax |
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Provider Business Mailing Address
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Address Line | 861 MARTIN LUTHER KING JR WAY STE 101
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City | HARRISONBURG
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State | VA
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Zip | 22801-3278
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Country | US
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Telephone | 540-442-3196
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Fax | 540-217-0298
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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 | 0024172944
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License Number State | VA
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