Provider Demographics
NPI:1023118429
Name:CUNNINGHAM, LANCEY IRENE (ARNP)
Entity type:Individual
Prefix:
First Name:LANCEY
Middle Name:IRENE
Last Name:CUNNINGHAM
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 MANOR DR
Mailing Address - Street 2:
Mailing Address - City:SINGER ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:33404-2742
Mailing Address - Country:US
Mailing Address - Phone:561-882-1541
Mailing Address - Fax:
Practice Address - Street 1:2482 PGA BLVD
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-3507
Practice Address - Country:US
Practice Address - Phone:561-622-8700
Practice Address - Fax:561-686-7252
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2014-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1121572363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily