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NPI Code Detail

MEDICARE: ITASHIA CUNNINGHAM APRN

MEDICARE: ITASHIA CUNNINGHAM APRN
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
1363LP0808XPsychiatric/Mental Health Nurse PractitionerAPRN3199062FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1APRN3199062OTHERFLSTATE LICENSE

General Provider Information

NPI Number : 1538275573
Entity Type Code : Individual
Provider Name (Legal Business Name) : ITASHIA CUNNINGHAM APRN
Provider Business Mailing Address
First Line : 1545 9TH ST SW
Second Line :
City : VERO BEACH
State : FL
Zip : 32962-4312
Country : US
Telephone Number : 772-257-8224
Fax Number : 772-213-3157
Provider Business Practice Location Address
First Line : 13505 US HIGHWAY 1
Second Line :
City : SEBASTIAN
State : FL
Zip : 32958-3759
Country : US
Telephone Number : 772-257-8224
Fax Number : 772-213-3157
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2006
Last Update Date : 04/22/2020

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Directions to “ ITASHIA CUNNINGHAM APRN” Practice Location

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