Provider Demographics
NPI:1699241968
Name:CUMMINGS, MISSY MARIE (NP)
Entity type:Individual
Prefix:
First Name:MISSY
Middle Name:MARIE
Last Name:CUMMINGS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5601 VETERANS PKWY
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31904-9001
Mailing Address - Country:US
Mailing Address - Phone:256-347-2506
Mailing Address - Fax:
Practice Address - Street 1:5601 VETERANS PKWY
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-9001
Practice Address - Country:US
Practice Address - Phone:706-321-6411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-15
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9492435363LA2200X
SC22172363LA2200X
NC5010846363LA2200X
AL1-084731363LA2200X
GARN276118363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health