Provider Demographics
NPI:1861528028
Name:CUNNINGHAM, ANNA GRACE (AUD, CCC-A)
Entity type:Individual
Prefix:DR
First Name:ANNA
Middle Name:GRACE
Last Name:CUNNINGHAM
Suffix:
Gender:F
Credentials:AUD, CCC-A
Other - Prefix:MS
Other - First Name:ANNA
Other - Middle Name:GRACE
Other - Last Name:HOILAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-A
Mailing Address - Street 1:1730 PLYMOUTH RD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55305-1970
Mailing Address - Country:US
Mailing Address - Phone:952-541-1799
Mailing Address - Fax:952-541-5451
Practice Address - Street 1:1730 PLYMOUTH RD
Practice Address - Street 2:SUITE 301
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55305-1970
Practice Address - Country:US
Practice Address - Phone:952-541-1799
Practice Address - Fax:952-541-5451
Is Sole Proprietor?:No
Enumeration Date:2007-02-24
Last Update Date:2013-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN7544231H00000X, 231HA2400X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Practitioner
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
640000285Medicare ID - Type Unspecified