Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | APRN11011736 | FL |
N | 363LW0102X | Nurse Practitioner - Women's Health | APRN11011736 | FL |
NPI | 1063006914 |
---|---|
Provider Name | Jennifer Lynn Cunningham |
First Address | Sarasota, FL 34231-4080 |
Second Address | Sarasota, FL 34231-4080 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2021 |
Last Update Date | 22/02/2021 |