Individual
MS. KANDI LYNN CUNNINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP-CNP
Contact information
Practice address
1200 E PECAN ST, ALTUS, OK 73521-6141
(580) 379-6100
(580) 379-6109
Mailing address
1200 E PECAN ST, ALTUS, OK 73521-6141
(580) 379-6100
(580) 379-6109
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
44356
OK
363LP0200X
Pediatric Nurse Practitioner
44356
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100125470C
—
OK
Enumeration date
09/21/2005
Last updated
10/14/2024
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