Provider Demographics
NPI:1063628378
Name:CUNNINGHAM, CARRIE LYNN (LPN)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:LYNN
Last Name:CUNNINGHAM
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1213 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:FORD CITY
Mailing Address - State:PA
Mailing Address - Zip Code:16226-1315
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2581 WASHINGTON RD
Practice Address - Street 2:SUMMERFIELD COMMONS SUITE 235
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15241-2564
Practice Address - Country:US
Practice Address - Phone:412-854-2080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN273384164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse