Provider Demographics
NPI:1285094664
Name:CUMMINGS, STEPHANIE J (CNP)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:J
Last Name:CUMMINGS
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2003 VETERANS BLVD
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45121-7408
Mailing Address - Country:US
Mailing Address - Phone:937-378-2900
Mailing Address - Fax:937-378-2951
Practice Address - Street 1:2003 VETERANS BLVD
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:OH
Practice Address - Zip Code:45121-7408
Practice Address - Country:US
Practice Address - Phone:937-378-2900
Practice Address - Fax:937-378-2951
Is Sole Proprietor?:No
Enumeration Date:2016-02-29
Last Update Date:2019-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.18703NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily