Provider Demographics
NPI:1477171270
Name:CUNNINGHAM, MARJI (APRN)
Entity Type:Individual
Prefix:DR
First Name:MARJI
Middle Name:
Last Name:CUNNINGHAM
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1403 HILL CREST AVE
Mailing Address - Street 2:N/A
Mailing Address - City:LAUREL
Mailing Address - State:MT
Mailing Address - Zip Code:59044
Mailing Address - Country:US
Mailing Address - Phone:406-366-4148
Mailing Address - Fax:
Practice Address - Street 1:801 N 29TH ST # A
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-0905
Practice Address - Country:US
Practice Address - Phone:406-238-2500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-08
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTNUR-APRN-LIC-101471363LG0600X
MT160165363LP2300X
MTNUR-APRN-LIC-160165363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care