Individual
TAMMY L CUNNINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
35349
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001720704
MSBCBS
WV
05
—
0068838000
—
WV
01
—
1071159
WORKERS COMP INDIVIDUAL
WV
Enumeration date
07/17/2006
Last updated
10/03/2013
Update your record
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