Provider Demographics
NPI:1194405134
Name:CUNNINGHAM, DANIELLE CHRISTIN (CPNP-PC)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:CHRISTIN
Last Name:CUNNINGHAM
Suffix:
Gender:F
Credentials:CPNP-PC
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:CHRISTIN
Other - Last Name:CARNIFAX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 KINGS HWY S
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14617-5504
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:200 NORTH ST STE 101
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:NY
Practice Address - Zip Code:14456-1561
Practice Address - Country:US
Practice Address - Phone:315-787-5200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-24
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY383545363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics