Provider Demographics
NPI:1619651668
Name:CUNNINGHAM, PAIGE (APRN-CNP)
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:
Last Name:CUNNINGHAM
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21220 ZOLMAN RD
Mailing Address - Street 2:
Mailing Address - City:FREDERICKTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:43019-9368
Mailing Address - Country:US
Mailing Address - Phone:740-398-9313
Mailing Address - Fax:740-399-8012
Practice Address - Street 1:11660 UPPER GILCHRIST RD
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:OH
Practice Address - Zip Code:43050-9084
Practice Address - Country:US
Practice Address - Phone:740-399-8008
Practice Address - Fax:740-399-8012
Is Sole Proprietor?:No
Enumeration Date:2023-06-12
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0033368363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner