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NPI Code Detail

MEDICARE: MS. KANDI LYNN CUNNINGHAM ARNP-CNP

MEDICARE: MS. KANDI LYNN CUNNINGHAM ARNP-CNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0200XPediatric Nurse Practitioner44356OK
2363L00000XNurse Practitioner44356OK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1326034778
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KANDI LYNN CUNNINGHAM ARNP-CNP
Provider Business Mailing Address
First Line : 1200 E PECAN ST
Second Line :
City : ALTUS
State : OK
Zip : 73521-6141
Country : US
Telephone Number : 580-379-6100
Fax Number : 580-379-6109
Provider Business Practice Location Address
First Line : 1200 E PECAN ST
Second Line :
City : ALTUS
State : OK
Zip : 73521-6141
Country : US
Telephone Number : 580-379-6100
Fax Number : 580-379-6109
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2005
Last Update Date : 10/14/2024

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