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NPI Code Detail

MEDICARE: PROF. NANCY H CUMMINGS EDD, ATC/L, CSCS

MEDICARE: PROF. NANCY H CUMMINGS EDD, ATC/L, CSCS
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
12255A2300XAthletic TrainerAL175FL

General Provider Information

NPI Number : 1598721664
Entity Type Code : Individual
Provider Name (Legal Business Name) : PROF. NANCY H CUMMINGS EDD, ATC/L, CSCS
Provider Business Mailing Address
First Line : 1936 BLUFF OAK ST
Second Line :
City : APOPKA
State : FL
Zip : 32712-3907
Country : US
Telephone Number : 321-439-2255
Fax Number :
Provider Business Practice Location Address
First Line : 111 LAKE HOLLINGSWORTH DR
Second Line : FLORIDA SOUTHERN COLLEGE
City : LAKELAND
State : FL
Zip : 33801-5607
Country : US
Telephone Number : 863-680-4262
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/26/2006
Last Update Date : 07/08/2007

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