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1538039490 NPI number — MATTIE CUNNINGHAM RN

NPI Number: 1538039490
Health Care Provider/Practitioner: MATTIE CUNNINGHAM RN

Information about “1538039490” NPI (MATTIE CUNNINGHAM RN) exists in 1538039490 in HTML format HTML  |  1538039490 in plain Text format TXT  |  1538039490 in PDF (Portable Document Format) PDF  |  1538039490 in an XML format XML  formats.

NPI Number : 1538039490 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1538039490",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "CUNNINGHAM",
    "FirstName": "MATTIE",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "RN",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1431 CEDAR COVE RD APT 826",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "LINCOLN",
    "MailingAddressStateName": "NE",
    "MailingAddressPostalCode": "68505-7872",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "402-875-7362",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "8207 NORTHWOODS DR",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "LINCOLN",
    "PracticeLocationAddressStateName": "NE",
    "PracticeLocationAddressPostalCode": "68505-2093",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "402-484-3440",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "11/06/2025",
    "LastUpdateDate": "11/06/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "163WD0400X",
        "TaxonomyName": "Diabetes Educator Registered Nurse",
        "LicenseNumber": "91695",
        "LicenseNumberStateCode": "NE",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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