Individual
MS. MARSHA MAE CUMMINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, CS, BC
Contact information
Practice address
2134 MARY SHERMAN DR, SULLIVAN, IN 47882-7625
(812) 268-6376
(812) 268-6377
Mailing address
1073 E COUNTY ROAD 250 N, SULLIVAN, IN 47882-7320
(859) 797-5422
Taxonomy
Speciality
Code
Description
License number
State
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
70000014A
IN
364SP0809X
Adult Psychiatric/Mental Health Clinical Nurse Specialist
Primary
70000014A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000513486
ANTHEM BLUE CROSS BLUE SHIELD
IN
05
—
200536950
—
IN
Enumeration date
03/13/2007
Last updated
12/11/2019
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