Doctor Name: | MRS. LOREN N CUNNINGHAM |
NPI Number: | 1235408261 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PAC |
License Number: | 01564 |
Business Practice Address: | 112 Kuykendall Lane Love Memorial Clinic Moorefield, WV - 26836 |
Business Phone Number: | 3045307755 |
Business Fax Number: | 3045307756 |
Mailing Address: | 112 Kuykendall Lane, Love Memorial Clinic MOOREFIELD |
State: | WV |
Postal Code: | 26836 |
Phone Number: | 3045307755 |
Fax Number: | 3045307756 |
NPI Enumeration Date: | 12/20/2011 |
NPI Last Update Date: | 12/21/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 01564 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WV |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |