Provider Demographics
NPI:1558745331
Name:CUNNINGHAM, LAURA RENE' (DNP, FNP-BC)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:RENE'
Last Name:CUNNINGHAM
Suffix:
Gender:F
Credentials:DNP, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 E UNIVERSITY DR STE 200
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85203-8308
Mailing Address - Country:US
Mailing Address - Phone:480-999-7911
Mailing Address - Fax:
Practice Address - Street 1:8877 W UNION HILLS DR STE A-160
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85382-3008
Practice Address - Country:US
Practice Address - Phone:480-999-7911
Practice Address - Fax:480-499-5829
Is Sole Proprietor?:No
Enumeration Date:2015-07-12
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE111848363LF0000X
AZ285718363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily