Individual
COLLEEN KEATING CUNNINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5970 FAIRVIEW RD STE 430, CHARLOTTE, NC 28210-3117
(704) 503-9884
Mailing address
5970 FAIRVIEW RD STE 430, CHARLOTTE, NC 28210-3117
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
12/30/2019
Last updated
01/11/2022
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