Provider Demographics
NPI:1205206091
Name:CUNNINGHAM, BRANDON MILES (FNP)
Entity Type:Individual
Prefix:MR
First Name:BRANDON
Middle Name:MILES
Last Name:CUNNINGHAM
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:861 MARTIN LUTHER KING JR WAY STE 101
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-3278
Mailing Address - Country:US
Mailing Address - Phone:540-442-3196
Mailing Address - Fax:540-217-0298
Practice Address - Street 1:861 MARTIN LUTHER KING JR WAY STE 101
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-3278
Practice Address - Country:US
Practice Address - Phone:540-290-1540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-06
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024172944363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily