Provider Demographics
NPI:1043904824
Name:FLADGER, CYNTINA LEE (REGISTERED NURSE)
Entity Type:Individual
Prefix:MRS
First Name:CYNTINA
Middle Name:LEE
Last Name:FLADGER
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:MISS
Other - First Name:CYNTINA
Other - Middle Name:LEE
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CYNTINA LEE TAYLOR
Mailing Address - Street 1:7365 WALTON WAY
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30135-6555
Mailing Address - Country:US
Mailing Address - Phone:404-447-1703
Mailing Address - Fax:470-222-8306
Practice Address - Street 1:7365 WALTON WAY
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30135-6555
Practice Address - Country:US
Practice Address - Phone:404-447-1703
Practice Address - Fax:470-222-8306
Is Sole Proprietor?:No
Enumeration Date:2023-06-06
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN211982163WH0200X, 163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator
No163WH0200XNursing Service ProvidersRegistered NurseHome Health