| Glen Martin Cunningham, FNP | |
|
2400 Sw Vermont St, Portland, OR 97219-1940 | |
| (503) 452-0915 | |
| Not Available |
| Full Name | Glen Martin Cunningham |
|---|---|
| Gender | Male |
| Speciality | Nurse Practitioner |
| Experience | 1 Years |
| Location | 2400 Sw Vermont St, Portland, Oregon |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871450460 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 10055208 (Oregon) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Fanno Creek Clinic Llc | 0042100521 | 24 |
| Entity Name | Fanno Creek Clinic LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1609876705 PECOS PAC ID: 0042100521 Enrollment ID: O20040318000244 |
| Mailing Address | Practice Location Address |
|---|---|
| Glen Martin Cunningham, FNP Po Box 27, Sublimity, OR 97385-0027 Ph: (541) 602-0047 | Glen Martin Cunningham, FNP 2400 Sw Vermont St, Portland, OR 97219-1940 Ph: (503) 452-0915 |
Mrs. Anjalee Nix Rowe, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3181 Sw Sam Jackson Park Rd, Portland, OR 97239 Phone: 503-494-3988 |
Ms. Susan Irene Smith, RN, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 5100 Sw Macadam Ave, Suite 200, Portland, OR 97239 Phone: 971-202-5500 Fax: 971-202-5555 |
Iva Juric, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 3181 Sw Sam Jackson Park Rd # Cdw6, Portland, OR 97239 Phone: 503-494-4808 |
Ms. Jessica A Dudley, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3550 N Interstate Ave, Portland, OR 97227 Phone: 503-746-1575 |
Summer Morgan Massina, ARNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 721 Nw 9th Ave Ste 100, Portland, OR 97209 Phone: 503-525-0090 |
Dr. Jeffery Wise, PMHNP-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1220 Sw Morrison St Ste 730, Portland, OR 97205 Phone: 971-354-9242 |
A'lissa Richards, PMHNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 12121 E Burnside St, Portland, OR 97216 Phone: 971-361-7700 |