Provider Demographics
NPI:1881355048
Name:CUMMINGS, DEMONICA (RN)
Entity type:Individual
Prefix:
First Name:DEMONICA
Middle Name:
Last Name:CUMMINGS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2604 ALDRICH ST APT 338
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-0015
Mailing Address - Country:US
Mailing Address - Phone:512-731-5187
Mailing Address - Fax:
Practice Address - Street 1:2604 ALDRICH ST APT 338
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723-0015
Practice Address - Country:US
Practice Address - Phone:512-731-5187
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-10
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory