Individual
MRS. JACQUELYN MARIE CUNNINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
ONE MEDICAL CENTER DR., MORGANTOWN, WV 26505
(304) 293-8266
Mailing address
PO BOX 923, ONE MEDICAL CENTER DR., MORGANTOWN, WV 26505
(304) 293-8266
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1119183
NCCPA CERTIFICATION NUMBER
WV
Enumeration date
09/08/2014
Last updated
04/15/2022
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