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General NPI Number Information
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NPI Number | 1598555443
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Entity Type | Individual
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Provider Name | MCKENSIE BOYD CUNNINGHAM CRNP
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Gender | Female
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Dates
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Enumeration Date | 05/12/2025
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Last Update Date | 05/12/2025
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Provider Practice Location Address
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Address Line | 2700 HOSPITAL DR
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City | NORTHPORT
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State | AL
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Zip | 35476-3360
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Country | US
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Telephone | 205-333-4500
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Fax |
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Provider Business Mailing Address
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Address Line | 13800 GILLIAM RD
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City | BERRY
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State | AL
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Zip | 35546-3809
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Country | US
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Telephone | 205-792-9057
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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 | 1-184008
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License Number State | AL
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