Individual
TYNEISHIA CUNNINGHAM KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1207 E FORREST ST STE 204D, ATHENS, AL 35613-2057
(256) 230-5280
(256) 427-4117
Mailing address
1207 E FORREST ST STE 204D, ATHENS, AL 35613-2057
(256) 301-5405
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1-115157
AL
363LF0000X
Family Nurse Practitioner
115157
AL
363LP0200X
Pediatric Nurse Practitioner
1-115157
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009937074
—
AL
Enumeration date
09/10/2019
Last updated
03/28/2022
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