Individual
JACQUELINE G CUNNINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
2537 EISENHOWER RD, OTTAWA, KS 66067-9482
(785) 242-3780
(785) 242-6397
Mailing address
PO BOX 677, OTTAWA, KS 66067-0677
(785) 242-3780
(785) 242-6397
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN 53-45786-061
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200439790A
—
KS
Enumeration date
07/19/2006
Last updated
03/12/2012
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