Provider Demographics
NPI:1760812457
Name:CUNNINGHAM, CHERISE
Entity Type:Individual
Prefix:
First Name:CHERISE
Middle Name:
Last Name:CUNNINGHAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 SHIRLEY AVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14215-1018
Mailing Address - Country:US
Mailing Address - Phone:716-602-5606
Mailing Address - Fax:
Practice Address - Street 1:32 SHIRLEY AVE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14215-1018
Practice Address - Country:US
Practice Address - Phone:716-602-5606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-18
Last Update Date:2013-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY655422-1163W00000X, 163WD1100X, 163WM0705X, 163WW0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
No163W00000XNursing Service ProvidersRegistered Nurse
No163WD1100XNursing Service ProvidersRegistered NurseDialysis, Peritoneal
No163WW0000XNursing Service ProvidersRegistered NurseWound Care