MEDICARE: CHRISTINA PAMELA 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
1	310400000X	Assisted Living Facility	0015887	WI

General Provider Information

NPI Number	:	1952024283
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA PAMELA CUNNINGHAM

Provider Business Mailing Address
First Line	:	8225B N 107TH ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53224-2511
Country	:	US
Telephone Number	:	414-573-8836
Fax Number	:	414-246-4271

Provider Business Practice Location Address
First Line	:	8225B N 107TH ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53224-2511
Country	:	US
Telephone Number	:	414-573-8836
Fax Number	:	414-246-4271

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/21/2022
Last Update Date	:	02/03/2026

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