1336379353 NPI number — MISS CYNTHIA ARLENE ALLEN FNP-C

Table of content: MISS CYNTHIA ARLENE ALLEN FNP-C (NPI 1336379353)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336379353 NPI number — MISS CYNTHIA ARLENE ALLEN FNP-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALLEN
Provider First Name:
CYNTHIA
Provider Middle Name:
ARLENE
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
FNP-C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MEYER
Provider Other First Name:
CYNTHNIA
Provider Other Middle Name:
ARLENE
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
RN
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1336379353
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/22/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 236
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BATESVILLE
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
47006-0236
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
812-933-5441
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
112 N BUCKEYE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OSGOOD
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
47037-1134
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
812-689-3424
Provider Business Practice Location Address Fax Number:
812-933-5237
Provider Enumeration Date:
07/24/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  71002962A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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