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General NPI Number Information
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NPI Number | 1538039490
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Entity Type | Individual
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Provider Name | MATTIE CUNNINGHAM RN
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Gender | Female
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Dates
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Enumeration Date | 11/06/2025
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Last Update Date | 11/06/2025
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Provider Practice Location Address
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Address Line | 8207 NORTHWOODS DR
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City | LINCOLN
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State | NE
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Zip | 68505-2093
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Country | US
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Telephone | 402-484-3440
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Fax |
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Provider Business Mailing Address
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Address Line | 1431 CEDAR COVE RD APT 826
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City | LINCOLN
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State | NE
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Zip | 68505-7872
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Country | US
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Telephone | 402-875-7362
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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 | 163WD0400X
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Taxonomy Name | Diabetes Educator Registered Nurse
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License Number | 91695
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License Number State | NE
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