Provider Demographics
NPI:1770029639
Name:CUNNINGHAM, MINDY PAIGE (PA-C)
Entity Type:Individual
Prefix:
First Name:MINDY
Middle Name:PAIGE
Last Name:CUNNINGHAM
Suffix:
Gender:F
Credentials:PA-C
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Other - Last Name:
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Mailing Address - Street 1:526 MOYE BLVD
Mailing Address - Street 2:2ND FLOOR CARDIOVASCULAR ICU
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-2848
Mailing Address - Country:US
Mailing Address - Phone:252-847-4707
Mailing Address - Fax:252-847-7613
Practice Address - Street 1:526 MOYE BLVD
Practice Address - Street 2:2ND FLOOR CARDIOVASCULAR ICU
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-2848
Practice Address - Country:US
Practice Address - Phone:252-847-4707
Practice Address - Fax:252-847-7613
Is Sole Proprietor?:No
Enumeration Date:2017-01-16
Last Update Date:2017-01-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC001006948363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical