Samantha Cunningham, CRNP

Key facts

NPI

1457950487

Entity type

Individual (NPI type 1)

Primary specialty

Nurse Practitioner 363L00000X

License

R202151 (MD)

Practice address

110 W Timonium Rd Ste 1C
Timonium, MD 21093-7302

Phone

(410) 561-5040

NPI assigned

Oct 21, 2020

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 1, 2022.

{
    "created_epoch": "1603238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661990400000",
    "number": "1457950487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 W TIMONIUM RD STE 1C",
            "city": "TIMONIUM",
            "state": "MD",
            "postal_code": "210937302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 W TIMONIUM RD STE 1C",
            "city": "TIMONIUM",
            "state": "MD",
            "postal_code": "210937302",
            "telephone_number": "410-561-5040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "SAMANTHA",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-21",
        "last_updated": "2022-09-01",
        "certification_date": "2022-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "R202151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Timonium, MD · Nurse Practitioner in Maryland