Individual
MS. MARY M CUMMINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C
Contact information
Practice address
4938 BROWNSBORO RD STE 206, LOUISVILLE, KY 40222-6385
(502) 339-2922
(502) 339-2912
Mailing address
801 YORK ST, MANITOWOC, WI 54220-4630
(920) 663-9008
(920) 684-1439
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA3213
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8101970
—
NC
Enumeration date
12/22/2005
Last updated
07/23/2024
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