Provider Demographics
NPI:1326786955
Name:CUMMINGS, STEPHANIE REGINA (LPN)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:REGINA
Last Name:CUMMINGS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:REGINA
Other - Last Name:CUMMINGS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPN
Mailing Address - Street 1:3230 C ST # 100
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-3918
Mailing Address - Country:US
Mailing Address - Phone:907-865-9653
Mailing Address - Fax:
Practice Address - Street 1:3230 C ST # 100
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-3918
Practice Address - Country:US
Practice Address - Phone:907-865-9653
Practice Address - Fax:907-865-9125
Is Sole Proprietor?:No
Enumeration Date:2022-05-24
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK104592164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse