Provider Demographics
NPI:1144103623
Name:CUNNINGHAM, DESTINEE JANET
Entity type:Individual
Prefix:
First Name:DESTINEE
Middle Name:JANET
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 1:11612 RUTHERFORD DR
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22407-6499
Mailing Address - Country:US
Mailing Address - Phone:540-834-8529
Mailing Address - Fax:
Practice Address - Street 1:11612 RUTHERFORD DR
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22407-6499
Practice Address - Country:US
Practice Address - Phone:540-834-8529
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-30
Last Update Date:2025-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA4681374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula