Individual
MISS MELISSA LYNN CUNNINGHAM-INGRAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1255 BELL RUN RD, FAIRMONT, WV 26554-1467
(304) 695-4901
Mailing address
1255 BELL RUN RD, FAIRMONT, WV 26554-1467
(304) 695-4901
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
28733
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28733
WV LPN BOARD
WV
Enumeration date
05/10/2021
Last updated
05/10/2021
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