Provider Demographics
NPI:1033313176
Name:TALBERT MAXWELL, CYNTHIA LUNETTE (RN PHN)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:LUNETTE
Last Name:TALBERT MAXWELL
Suffix:
Gender:F
Credentials:RN PHN
Other - Prefix:MRS
Other - First Name:CYNTHIA
Other - Middle Name:LUNETTE
Other - Last Name:AVEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:607 W MAIN ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MARSHALL
Mailing Address - State:MN
Mailing Address - Zip Code:56258-3169
Mailing Address - Country:US
Mailing Address - Phone:507-537-6713
Mailing Address - Fax:
Practice Address - Street 1:607 W MAIN ST
Practice Address - Street 2:SUITE 200
Practice Address - City:MARSHALL
Practice Address - State:MN
Practice Address - Zip Code:56258-3169
Practice Address - Country:US
Practice Address - Phone:507-537-6713
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2013-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR1300330163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse