Individual
CARRIE M CUNNINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
2200 S MAIN ST, PARIS, IL 61944
(217) 463-4340
(217) 463-4342
Mailing address
2200 S MAIN ST, PARIS, IL 61944-2966
(217) 463-4340
(217) 463-4342
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209.017707
IL
363LF0000X
Family Nurse Practitioner
28179464A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000740975
ANTHEM
IN
05
—
201029170
—
IN
Enumeration date
02/23/2011
Last updated
07/27/2018
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