Provider Demographics
NPI:1477890887
Name:CUMMINS, DONIECE ROSS (RN, ANP-BC)
Entity Type:Individual
Prefix:MS
First Name:DONIECE
Middle Name:ROSS
Last Name:CUMMINS
Suffix:
Gender:F
Credentials:RN, ANP-BC
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Mailing Address - Street 1:2490 RIVERSIDE DR
Mailing Address - Street 2:STE B
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31204-1787
Mailing Address - Country:US
Mailing Address - Phone:478-633-6633
Mailing Address - Fax:478-633-4295
Practice Address - Street 1:1014 FORSYTH ST
Practice Address - Street 2:SUITE 100
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31201-2051
Practice Address - Country:US
Practice Address - Phone:478-633-8700
Practice Address - Fax:478-633-8710
Is Sole Proprietor?:No
Enumeration Date:2013-01-07
Last Update Date:2015-06-20
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Provider Licenses
StateLicense IDTaxonomies
GARN217465163W00000X, 363LA2200X
TX2-44278163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003144049BMedicaid