Provider Demographics
NPI:1316204902
Name:CUNNINGHAM, SEMYYA (MSN, RN)
Entity Type:Individual
Prefix:
First Name:SEMYYA
Middle Name:
Last Name:CUNNINGHAM
Suffix:
Gender:F
Credentials:MSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 492
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22038-0492
Mailing Address - Country:US
Mailing Address - Phone:571-245-8833
Mailing Address - Fax:
Practice Address - Street 1:13016 POINT PLEASANT DR
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22033-3512
Practice Address - Country:US
Practice Address - Phone:571-245-8833
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-19
Last Update Date:2012-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VARN0001183197163W00000X
MDR155762163W00000X
DCRN1016274163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse