Individual
KASSANDRA B. CUNNINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
10103 RIDGEGATE PKWY STE 103, LONE TREE, CO 80124-5524
(303) 645-0090
(303) 645-0092
Mailing address
4900 S MONACO ST, SUITE 210, DENVER, CO 80237-3486
(303) 645-0090
(303) 645-0092
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1962
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
275747YPNQ
MEDICARE
CO
05
—
57575509
—
CO
Enumeration date
03/14/2008
Last updated
07/21/2022
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