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NPI Code Detail

MEDICARE: KRISTIN R CUNNINGHAM PMHNP

MEDICARE: KRISTIN R CUNNINGHAM PMHNP
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
12084P0800XPsychiatry Physician53-81805-062KS

General Provider Information

NPI Number : 1528773512
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTIN R CUNNINGHAM PMHNP
Provider Business Mailing Address
First Line : 1045 E 23RD ST
Second Line :
City : LAWRENCE
State : KS
Zip : 66046-5003
Country : US
Telephone Number : 785-393-6167
Fax Number :
Provider Business Practice Location Address
First Line : 1045 E 23RD ST
Second Line :
City : LAWRENCE
State : KS
Zip : 66046-5003
Country : US
Telephone Number : 785-393-6167
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/16/2023
Last Update Date : 01/16/2023

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