Provider Demographics
NPI:1710378666
Name:CUNNINGHAM, KATHARINE (RN)
Entity Type:Individual
Prefix:
First Name:KATHARINE
Middle Name:
Last Name:CUNNINGHAM
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5621 COTTONWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66216-5009
Mailing Address - Country:US
Mailing Address - Phone:913-530-1265
Mailing Address - Fax:913-248-1714
Practice Address - Street 1:5621 COTTONWOOD DR
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:KS
Practice Address - Zip Code:66216-5009
Practice Address - Country:US
Practice Address - Phone:913-530-1265
Practice Address - Fax:913-248-1714
Is Sole Proprietor?:No
Enumeration Date:2015-02-13
Last Update Date:2015-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS14-118210-112163WH0200X
MO2010034805163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health