Provider Demographics
NPI:1043580186
Name:NELLY, CINDY ANN (ARNP,CNM)
Entity Type:Individual
Prefix:MS
First Name:CINDY
Middle Name:ANN
Last Name:NELLY
Suffix:
Gender:F
Credentials:ARNP,CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1920 SW 8TH DR
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32601-8415
Mailing Address - Country:US
Mailing Address - Phone:352-219-5338
Mailing Address - Fax:
Practice Address - Street 1:1920 SW 8TH DR
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32601-8415
Practice Address - Country:US
Practice Address - Phone:352-219-5338
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-06
Last Update Date:2012-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9165405367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife