Provider Demographics
NPI:1720141559
Name:CUMMINGS, MARSHA L (PA-C)
Entity Type:Individual
Prefix:
First Name:MARSHA
Middle Name:L
Last Name:CUMMINGS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2090 NEVADA CITY HWY
Mailing Address - Street 2:
Mailing Address - City:GRASS VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95945-7702
Mailing Address - Country:US
Mailing Address - Phone:530-274-5020
Mailing Address - Fax:
Practice Address - Street 1:2090 NEVADA CITY HWY
Practice Address - Street 2:
Practice Address - City:GRASS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95945-7702
Practice Address - Country:US
Practice Address - Phone:530-274-5020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2011-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13281363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant