Individual
MR. BRIAN R CUNNINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP-BC
Contact information
Practice address
982 CHAMBERS ST, SOUTH OGDEN, UT 84403-4571
(801) 582-1565
Mailing address
982 CHAMBERS ST, SOUTH OGDEN, UT 84403-4571
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP60301512
WA
Other
Enumeration date
08/13/2012
Last updated
06/13/2013
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