Basic Information
| Provider Information | |||||||||
| NPI: | 1457736613 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CUMMINGS | ||||||||
| FirstName: | CORINNE | ||||||||
| MiddleName: | E | ||||||||
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| Credential: | APN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7000 ATRIUM WAY | ||||||||
| Address2: | STE. 6 | ||||||||
| City: | MOUNT LAUREL | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080543917 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8562916818 | ||||||||
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| Practice Location | |||||||||
| Address1: | 401 YOUNG AVE | ||||||||
| Address2: | SUITE 260 | ||||||||
| City: | MOORESTOWN | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080573130 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8562918756 | ||||||||
| FaxNumber: | 8562918750 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/29/2015 | ||||||||
| LastUpdateDate: | 10/16/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 10/16/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 26NJ00598700 | NJ | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 163W00000X | 26NR16652700 | NJ | N | Nursing Service Providers | Registered Nurse |
No ID Information.