Individual
DESTINY CUNNINGHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
1550 N ENCOURE WAY, CLOVIS, CA 93619-8034
(818) 441-2306
Mailing address
PO BOX 26735, FRESNO, CA 93729-6735
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
276511
CA
Other
Enumeration date
04/01/2018
Last updated
04/01/2018
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