Individual
STEPHANIE DIANE CUNNINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4605 MACCORKLE AVE SW, SOUTH CHARLESTON, WV 25309-1311
(304) 766-3600
Mailing address
110 ROANE ST, CHARLESTON, WV 25302-2334
(304) 344-0096
(304) 342-4725
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
73248
WV
367500000X
Certified Registered Nurse Anesthetist
Primary
90763
WV
Other
Enumeration date
04/01/2013
Last updated
03/10/2014
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