Individual
HANNAH CUNNINGHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1385 E MAIN ST, CARBONDALE, IL 62901-3116
(618) 457-5200
Mailing address
2401 W MAIN ST, MARION, IL 62959-1188
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041481513
IL
363LF0000X
Family Nurse Practitioner
Primary
209030810
IL
Other
Enumeration date
07/01/2024
Last updated
10/18/2024
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