Provider Demographics
NPI:1083605968
Name:GUERCIO, CYNTHIA V (CNM)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:V
Last Name:GUERCIO
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 HOSPITAL SOUTH DR. SUITE 500
Mailing Address - Street 2:SOUTH COBB OB-GYN
Mailing Address - City:AUSTELL
Mailing Address - State:GA
Mailing Address - Zip Code:30106
Mailing Address - Country:US
Mailing Address - Phone:770-941-7717
Mailing Address - Fax:770-739-9384
Practice Address - Street 1:1700 HOSPITAL SOUTH DR. SUITE 500
Practice Address - Street 2:SOUTH COBB OB-GYN
Practice Address - City:AUSTELL
Practice Address - State:GA
Practice Address - Zip Code:30106
Practice Address - Country:US
Practice Address - Phone:770-941-7717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2014-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2798652367A00000X
GARN197647367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL304425400Medicaid
FLE7822ZMedicare ID - Type Unspecified
FLP64649Medicare UPIN