| Doctor Name: | KERIN CUMMINS |
| NPI Number: | 1023446770 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APN |
| License Number: | 209010770 |
| Business Practice Address: | 1200 W State St Rockford, IL - 611022112 |
| Business Phone Number: | 8154901600 |
| Business Fax Number: | 8154901485 |
| Mailing Address: | 1200 W State St, ROCKFORD |
| State: | IL |
| Postal Code: | 611022112 |
| Phone Number: | 8154901600 |
| Fax Number: | 8154901485 |
| NPI Enumeration Date: | 10/16/2013 |
| NPI Last Update Date: | 10/16/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | 209010770 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |