Provider Demographics
NPI:1912651274
Name:CUNNINGHAM-NEVEL, ANNE MONIQUE
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:MONIQUE
Last Name:CUNNINGHAM-NEVEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4010 LANGDRUM DR
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33543-7900
Mailing Address - Country:US
Mailing Address - Phone:813-352-1431
Mailing Address - Fax:
Practice Address - Street 1:4010 LANGDRUM DR
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33543-7900
Practice Address - Country:US
Practice Address - Phone:813-352-1431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-07
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL5672-5-GC373H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL021912500Medicaid