Individual
CYNTHIA J CUNNINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
133 BROOKLINE AVE, BOSTON, MA 02215-3904
(617) 421-1000
Mailing address
147 MILK ST, PROVIDER ENROLLMENT - 9TH FLOOR, BOSTON, MA 02109-4806
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
163712
MA
363LP0200X
Pediatric Nurse Practitioner
Primary
163712
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0376213
—
MA
01
—
NP1290
BLUE CROSS
MA
01
—
PF305
HARVARD PILGRIM
MA
Enumeration date
02/13/2006
Last updated
06/11/2012
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