Provider Demographics
NPI:1376948448
Name:COLLEEN CUMMING
Entity Type:Organization
Organization Name:COLLEEN CUMMING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE
Authorized Official - Prefix:
Authorized Official - First Name:COLLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:CUMMING
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:978-804-7820
Mailing Address - Street 1:63 NORTH ST
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01810-1105
Mailing Address - Country:US
Mailing Address - Phone:978-804-7820
Mailing Address - Fax:
Practice Address - Street 1:63 NORTH ST
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01810-1105
Practice Address - Country:US
Practice Address - Phone:978-804-7820
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-30
Last Update Date:2014-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN285247251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health