Provider Demographics
NPI:1598555443
Name:CUNNINGHAM, MCKENSIE BOYD (CRNP)
Entity type:Individual
Prefix:MRS
First Name:MCKENSIE
Middle Name:BOYD
Last Name:CUNNINGHAM
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13800 GILLIAM RD
Mailing Address - Street 2:
Mailing Address - City:BERRY
Mailing Address - State:AL
Mailing Address - Zip Code:35546-3809
Mailing Address - Country:US
Mailing Address - Phone:205-792-9057
Mailing Address - Fax:
Practice Address - Street 1:2700 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:NORTHPORT
Practice Address - State:AL
Practice Address - Zip Code:35476-3360
Practice Address - Country:US
Practice Address - Phone:205-333-4500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-12
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-184008363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily