Provider Demographics
NPI:1114277084
Name:CUNNINGHAM, KRISTINA
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:
Last Name:CUNNINGHAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13511 S MUR LEN RD
Mailing Address - Street 2:SUITE 128
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-1671
Mailing Address - Country:US
Mailing Address - Phone:913-276-5858
Mailing Address - Fax:913-276-5859
Practice Address - Street 1:13511 S MUR LEN RD
Practice Address - Street 2:SUITE 128
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-1671
Practice Address - Country:US
Practice Address - Phone:913-276-5858
Practice Address - Fax:913-276-5859
Is Sole Proprietor?:No
Enumeration Date:2012-09-18
Last Update Date:2016-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1503237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS36832026OtherBCBS-KC