Provider Demographics
NPI:1033688031
Name:NAVARRO, CYNTHIA MARIE (LPN)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:MARIE
Last Name:NAVARRO
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:MARIE
Other - Last Name:BOLDUC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-4959
Mailing Address - Country:US
Mailing Address - Phone:978-740-2300
Mailing Address - Fax:
Practice Address - Street 1:2 1ST AVE
Practice Address - Street 2:
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-4959
Practice Address - Country:US
Practice Address - Phone:978-740-2300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-19
Last Update Date:2018-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA34478164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse