Provider Demographics
NPI:1679167654
Name:CUNNINGHAM, ABBY (CRNP)
Entity type:Individual
Prefix:
First Name:ABBY
Middle Name:
Last Name:CUNNINGHAM
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 E BROWN ST
Mailing Address - Street 2:
Mailing Address - City:EAST STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18301-3013
Mailing Address - Country:US
Mailing Address - Phone:272-212-4000
Mailing Address - Fax:866-230-6623
Practice Address - Street 1:235 E BROWN ST
Practice Address - Street 2:
Practice Address - City:EAST STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18301-3013
Practice Address - Country:US
Practice Address - Phone:272-212-4000
Practice Address - Fax:866-230-6623
Is Sole Proprietor?:No
Enumeration Date:2021-02-22
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP022260363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health