Individual
MR. KENNETH MICHAEL CUNNINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
5319 HOAG DRIVE, ELYRIA, OH 44035-1494
(440) 930-6050
Mailing address
13523 BARRETT PARKWAY DRIVE, SUITE 104, BALLWIN, MO 63021-3802
(636) 938-6868
(636) 938-1486
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
150955
OH
367500000X
Certified Registered Nurse Anesthetist
Primary
RN-150955
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0816086
—
OH
Enumeration date
08/11/2005
Last updated
09/28/2010
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