Provider Demographics
NPI:1992437321
Name:CUNNINGHAM, EVA KIRSTEN
Entity type:Individual
Prefix:MRS
First Name:EVA
Middle Name:KIRSTEN
Last Name:CUNNINGHAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17925 SECO ST APT 40
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:CA
Mailing Address - Zip Code:95327-9111
Mailing Address - Country:US
Mailing Address - Phone:209-984-6975
Mailing Address - Fax:
Practice Address - Street 1:17925 SECO ST APT 40
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:CA
Practice Address - Zip Code:95327-9111
Practice Address - Country:US
Practice Address - Phone:209-984-6975
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-24
Last Update Date:2022-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care