Cunningham, Shannon M

Cunningham, Shannon M is an individual health care provider with primary practice located at 8501 Arlington Blvd Suite 550, Fairfax VA 22032-4625. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Cunningham, Shannon M can be contacted via phone (703) 810-5219.

Contact Information

Primary practice address
8501 Arlington Blvd Suite 550 Fairfax VA 22032-4625
Phone: (703) 810-5219
Fax: (703) 810-5406
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X R083823 Maryland

Profile Details

NPI number 1275524423
LBN Legal business name Cunningham, Shannon M
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 4th, 2005
Last updated Jan 25th, 2012 - about 12 years ago

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275524423 NPPES
Maryland Other 430074296 RR MEDICARE
Maryland MEDICAID 4191757 00 RR MEDICARE
Maryland Other KBC1CH RR MEDICARE
Maryland Other S417-0011 RR MEDICARE

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