Provider Demographics
NPI:1033178926
Name:L'HEUREUX, CYNTHIA D (APRN)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:D
Last Name:L'HEUREUX
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1403 HOPEVILLE RD
Mailing Address - Street 2:
Mailing Address - City:GRISWOLD
Mailing Address - State:CT
Mailing Address - Zip Code:06351-1614
Mailing Address - Country:US
Mailing Address - Phone:860-376-0692
Mailing Address - Fax:
Practice Address - Street 1:85 POHEGANUT DR
Practice Address - Street 2:
Practice Address - City:GROTON
Practice Address - State:CT
Practice Address - Zip Code:06340-3216
Practice Address - Country:US
Practice Address - Phone:860-448-6303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-21
Last Update Date:2011-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001296363LG0600X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT000Medicaid
CTP18617Medicare UPIN
CTC03140Medicare ID - Type Unspecified