Individual
MR. THOMAS ELIAS CUNNINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
5305 W VILLAGE PKWY STE 12, ROGERS, AR 72758-8116
(479) 480-4892
Mailing address
14801 PARK RIDGE DRIVE, LOWELL, AR 72745
(479) 295-6325
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
0057700
OK
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
A03250
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200109330A
—
OK
Enumeration date
04/19/2007
Last updated
09/07/2023
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