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Individual

JASON L CUNNINGHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1222 TROTWOOD AVE, SUITE 101, COLUMBIA, TN 38401-6436
(931) 490-7348
(931) 490-7349
Mailing address
854 W JAMES CAMPBELL BLVD, SUTIE 303, COLUMBIA, TN 38401-4659
(931) 490-7348
(931) 490-7349

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
20553
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3710089
TN
Enumeration date
10/06/2015
Last updated
10/06/2015
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