1154544120 NPI number — MS. CYNTHIA ANNE HYDE ARNP CNM MPH

Table of content: MS. CYNTHIA ANNE HYDE ARNP CNM MPH (NPI 1154544120)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154544120 NPI number — MS. CYNTHIA ANNE HYDE ARNP CNM MPH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HYDE
Provider First Name:
CYNTHIA
Provider Middle Name:
ANNE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
ARNP CNM MPH
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1154544120
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
27941 560TH AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AMES
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
50010-9333
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
515-233-1679
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2679 MAURY ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DES MOINES
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
50317-7462
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
515-244-6162
Provider Business Practice Location Address Fax Number:
515-266-3105
Provider Enumeration Date:
04/10/2007

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: 367A00000X , with the licence number:  088970 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 088970 . This is a "STATE ARNP LICENSE" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".




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