Cunningham, Jennifer M
Cunningham, Jennifer M is an individual health care provider with primary practice located at 704 S Webster Ave , Green Bay WI 54301-3528. She recently has only one registered license in Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism, which is considered as her primary health care specialty. Cunningham, Jennifer M can be contacted via phone (920) 433-6050.Contact Information
Primary practice address
704 S Webster Ave
Green Bay WI 54301-3528
Phone: (920) 433-6050
Fax: (920) 433-6049
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism | 207RE0101X | 3258-320 | Wisconsin |
Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism | 207RE0101X | 036-094893 | Illinois |
Profile Details
NPI number | 1790771962 |
---|---|
LBN Legal business name | Cunningham, Jennifer M |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Sep 23rd, 2005 |
Last updated | Oct 5th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1790771962 | NPPES |
Illinois | Other | 01633083 | BCBS IL |
Illinois | Other | 383649745 | BCBS IL |
Illinois | MEDICAID | 036094893 | BCBS IL |
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