Provider Demographics
NPI:1831426444
Name:CUNNINGHAM, LINDSEY ANNE (CAA)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:ANNE
Last Name:CUNNINGHAM
Suffix:
Gender:F
Credentials:CAA
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:ANNE
Other - Last Name:STARK MCCRAMMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3355 GLENDALE AVE FL 3
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614-2426
Mailing Address - Country:US
Mailing Address - Phone:419-383-5322
Mailing Address - Fax:419-383-6235
Practice Address - Street 1:3000 ARLINGTON AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614-2595
Practice Address - Country:US
Practice Address - Phone:419-383-3556
Practice Address - Fax:419-383-3550
Is Sole Proprietor?:No
Enumeration Date:2009-11-03
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
367H00000X
IN75000016A367H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3037207Medicaid
IN000001260386OtherANTHEM PTAN