Provider Demographics
NPI:1205205010
Name:CUNNINGHAM, CORINA CHRISTINE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:CORINA
Middle Name:CHRISTINE
Last Name:CUNNINGHAM
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:CORINA
Other - Middle Name:CHRISTINE
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:255 S DOBSON RD
Mailing Address - Street 2:STE 1
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-6231
Mailing Address - Country:US
Mailing Address - Phone:480-722-2595
Mailing Address - Fax:480-722-2599
Practice Address - Street 1:255 S DOBSON RD
Practice Address - Street 2:STE 1
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224
Practice Address - Country:US
Practice Address - Phone:480-722-2595
Practice Address - Fax:480-722-2599
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-22
Last Update Date:2019-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ6177363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical