Provider Demographics
NPI:1316252547
Name:CUNNINGHAM, ELIZABETH A (CPNP)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:A
Last Name:CUNNINGHAM
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:A
Other - Last Name:TADIJANAC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CPNP
Mailing Address - Street 1:3300 RIVERSIDE DRIVE, SUITE 200
Mailing Address - Street 2:
Mailing Address - City:UPPER ARLINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43221-1738
Mailing Address - Country:US
Mailing Address - Phone:614-459-4200
Mailing Address - Fax:614-459-1589
Practice Address - Street 1:3300 RIVERSIDE DRIVE, SUITE 200
Practice Address - Street 2:
Practice Address - City:UPPER ARLINGTON
Practice Address - State:OH
Practice Address - Zip Code:43221-1738
Practice Address - Country:US
Practice Address - Phone:614-459-4200
Practice Address - Fax:614-459-1589
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-12
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.11133-NP363LP0200X
OH11133-NP363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics