Provider Demographics
NPI:1942751490
Name:CUMMINS, EMY LYNN (NMD)
Entity type:Individual
Prefix:DR
First Name:EMY
Middle Name:LYNN
Last Name:CUMMINS
Suffix:
Gender:F
Credentials:NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17150 N 23RD ST UNIT 146
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85022-2277
Mailing Address - Country:US
Mailing Address - Phone:361-548-9024
Mailing Address - Fax:
Practice Address - Street 1:1702 E BETHANY HOME RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-2536
Practice Address - Country:US
Practice Address - Phone:480-524-0076
Practice Address - Fax:480-637-0184
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-19
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ16-1581175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath