Provider Demographics
NPI:1184228769
Name:CUNNINGHAM, DARLENE DENICE (BS, RN, MA, CDDN)
Entity Type:Individual
Prefix:MS
First Name:DARLENE
Middle Name:DENICE
Last Name:CUNNINGHAM
Suffix:
Gender:F
Credentials:BS, RN, MA, CDDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11469 OLIVE BLVD STE 1212
Mailing Address - Street 2:
Mailing Address - City:CREVE COEUR
Mailing Address - State:MO
Mailing Address - Zip Code:63141-7108
Mailing Address - Country:US
Mailing Address - Phone:888-485-6111
Mailing Address - Fax:
Practice Address - Street 1:8425 ALDER S
Practice Address - Street 2:
Practice Address - City:ST LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63134
Practice Address - Country:US
Practice Address - Phone:888-485-6111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-24
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO098034163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator