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NPI Code Detail

MEDICARE: AIMEE CUNNINGHAM

MEDICARE: AIMEE CUNNINGHAM
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
1133V00000XRegistered Dietitian86082753MO

General Provider Information

NPI Number : 1346729472
Entity Type Code : Individual
Provider Name (Legal Business Name) : AIMEE CUNNINGHAM
Provider Business Mailing Address
First Line : 352 TULIP DR
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63119-4561
Country : US
Telephone Number : 314-740-5603
Fax Number :
Provider Business Practice Location Address
First Line : 2727 WASHINGTON AVE
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63103-1421
Country : US
Telephone Number : 314-652-4100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2018
Last Update Date : 08/09/2018

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Directions to “ AIMEE CUNNINGHAM ” Practice Location

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