Provider Demographics
NPI:1043963986
Name:BATIE, CYNTHIA (RPH)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:BATIE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 CAJUN LN
Mailing Address - Street 2:
Mailing Address - City:EDGEWOOD
Mailing Address - State:NM
Mailing Address - Zip Code:87015-9134
Mailing Address - Country:US
Mailing Address - Phone:505-259-0516
Mailing Address - Fax:
Practice Address - Street 1:2B STATE ROAD 344
Practice Address - Street 2:
Practice Address - City:EDGEWOOD
Practice Address - State:NM
Practice Address - Zip Code:87015-6951
Practice Address - Country:US
Practice Address - Phone:505-286-9040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-01
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM00005585183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist