Provider Demographics
NPI:1760259196
Name:CUNNINGHAM, RYAN NICHOLAS
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:NICHOLAS
Last Name:CUNNINGHAM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6572 KIRKLAND DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45224-1634
Mailing Address - Country:US
Mailing Address - Phone:513-226-5309
Mailing Address - Fax:
Practice Address - Street 1:6572 KIRKLAND DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45224-1634
Practice Address - Country:US
Practice Address - Phone:513-226-5309
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-06
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant