Provider Demographics
NPI:1235369356
Name:CUNNINGHAM, VICTORIAANN M (RN)
Entity Type:Individual
Prefix:MS
First Name:VICTORIAANN
Middle Name:M
Last Name:CUNNINGHAM
Suffix:
Gender:F
Credentials:RN
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Mailing Address - Street 1:2 MURRAY HILL DR.
Mailing Address - Street 2:LIVINGSTON COUNTY HEALTH DEPT.
Mailing Address - City:MT. MORRIS
Mailing Address - State:NY
Mailing Address - Zip Code:14510-1691
Mailing Address - Country:US
Mailing Address - Phone:585-243-7540
Mailing Address - Fax:585-243-7287
Practice Address - Street 1:2 MURRAY HILL DR
Practice Address - Street 2:LIVINGSTON COUNTY DEPT. OF HEALTH
Practice Address - City:MOUNT MORRIS
Practice Address - State:NY
Practice Address - Zip Code:14510-1122
Practice Address - Country:US
Practice Address - Phone:585-243-7540
Practice Address - Fax:585-243-7287
Is Sole Proprietor?:No
Enumeration Date:2009-07-23
Last Update Date:2009-07-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY369807-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY166002561Medicaid